Sept./Oct. | 2009
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Don't be a Professional BULLY
Intervention is key to changing behavior

Did you know that 40 percent of clinicians who have experienced intimidation in the workplace have kept quiet about it? We're talking about disruptive behaviors that occur between co-workers when one treats the other with disrespect: yelling, belittling, throwing things, derogatory comments, and/or even threatening physical contact.

All HeartYou may think bullying is reserved for elementary school, but The Joint Commission says that “most” clinicians have witnessed some type of disruptive behavior at work. So concerned was TJC about these statistics that it alerted health care organizations last year to be on the lookout for such behavior because it has a negative effect on patient safety and quality of care.

Example:  a nurse manager loses patience with a staff member who is stressed about workload. The manager shouts and leaves the room, slamming the door on the way out. The nurse starts her shift in tears.

The Joint Commission directive focused on the connection between disruptive behavior and patient safety, linking inappropriate acts to increased medical errors and adverse outcomes. It reduces staff morale and performance, and can lead to staff turnover. This leads to increased cost of care and patient dissatisfaction. The new TJC standard focuses on encouraging behavior that supports open, non-hierarchical communication among all who work within the organization.

That focus was the foundation for the disruptive behavior policy the Health System implemented in January 2009 for all employees. In addition to outlining types of behavior that are encouraged and prohibited at the Health System, the policy also provides avenues to report this behavior.

“The institution is interested in addressing behavior that undermines a culture of patient safety,” says Heather Wurster, R.N., M.P.H., administrative director, Office of Clinical Affairs. “That the Joint Commission says 40 percent of people don’t report this type of behavior is unsettling. We are working to change our culture so that employees aren’t afraid to speak up when treated in a disrespectful or disruptive manner.”

Example: an administrator knocks on the open door of a physician, who turns and angrily snaps that he is too busy to talk to someone like her. Before she can speak, the physician stands and escorts her out of the room and closes the door in her face.

Health System leaders hope to empower employees to overcome any perceived sense of being trapped by the “status quo.”  The policy clearly encourages reporting, defines behavior expectations and outlines the procedure to report, including an anonymous option.

Wurster, whose job includes intervening when a U-M physician exhibits disruptive behavior, says individuals are often not aware of the impact they are having on their co-workers. A person coming forward to report an incident is the only way to change the situation. “People are worth the investment,” Wurster says  “We have many success stories - intervention leads to insight which leads to changed behavior.”

Written by Beth Johnson

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