Joint Commission: disruptive behavior is bad. Very bad.

The Joint Commission has released a sentinel event alert, Behaviors that undermine a culture of safety, that addresses issues near and dear to my heart, as regular readers will know. Effective January 2009, the Joint Commission has added two leadership initiatives that address “disruptive and inappropriate behavior.” Why? It leads to sentinel events (a sentinel event is “is an unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof”)! Not only does disruptive behavior ultimately expose health care institutions to lawsuits—

“Studies link patient complaints about unprofessional, disruptive behaviors and malpractice risk.”

but it also increases costs and decreases staff retention (relevant because, if you haven’t heard, there’s a nursing shortage):

“Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments.”

Basically, The Joint Commission is adding to our duties as health care providers to grow backbones and address bad behavior like adults instead of bitching about it to people who can’t do anything about it. They’re guilting us into it by reminding us that we really are all grownups and that patient safety and outcomes are at stake—as well they should!

It is interesting that bickering and back-stabbing in hospitals have reached a level critical enough to invite Joint Commission initiatives. My unit at work is emphasizing this lately, and oh boy does it need to. Our nursing director has even instituted a hand signal (a “talk to the hand” kind of dealio) that we should use when someone is gossiping or behaving inappropriately. We had a mandatory staff meeting on acting like adults.

Let us remember that it’s not just our egos and our comfort in the workplace at stake when folks aren’t getting along; miscommunication or noncommunication as a result of fear, anger, or simple pique could cause our next error that leads to patient harm. Yikes.

3 Responses to “Joint Commission: disruptive behavior is bad. Very bad.”


  1. 1 Jacob July 14, 2008 at 2:32 pm

    Hear, hear.

    I just started a new position on a new unit and I have never heard such gossiping and backstabbing. I’m wondering how long it will be before management has a meeting with us about the new Joint Commission policies.

    I remember reading about a unit at some hospital in Canada that adopted a voluntary no-gossip policy that charged them money for gossiping. They said after just a few weeks morale improved greatly, and patients were commenting on how happy the staff were.

    Nice post.

  2. 2 Jeff July 14, 2008 at 6:58 pm

    I just graduated last year (with RN), and the level of viciousness and vitriol I heard during clinicals made me want to quit school and go back to my previous field. The teachers kept saying “nurses eat their young,” but it sounded to me more like “nurses hate nurses.” Luckily I work at a place where we say what we are thinking right away and don’t let it fester, and then we get over it and continue with our jobs.

    Good topic for a post.
    regards

  3. 3 Wanderer July 14, 2008 at 7:45 pm

    When I read the line about, “inappropriate and disruptive behaviors” I thought the Joint Commission had finally come to their senses and decided that we could gork the every-loving-snot out of our patients of that variety, Then I read the rest. Oh, well. It was at least at thought.

    Maybe we can get the Joint Commission to somehow work this around to enable us to give Ativan to families that showcase this behavior (especially the intimidating part). One can dream!

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