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Why Do We Tolerate Behaviors that Put Patients at Risk?

December 17, 2015

Whether it's outright disruptive behavior or the inability to consistently comply with procedures, the behaviors of physicians, nurses and staff can put patients at risk. These nursebehaviors are pervasive and, apparently, tolerated.

A 2009 survey by the American College of Physician Executives found that disruptive behaviors are rampant in some organizations, and that these behaviors can have negative consequences for patients. Ninety-seven percent of 13,000 physician and nurse executives experienced unprofessional outbursts and overreactions, with most saying these happened several times a year and sometimes even weekly, and they can put patients at risk. An extreme example:

"A nurse witnessed the onset of complications in an intensive care patient but refused to contact the on-call physician for fear of his temper - a delay at least one observer thought contributed to the patient's death."
Bad Blood: Doctor-Nurse Behavior Problems Impact Patient Care, American College of Physician Executives 2009 Doctor-Nurse Behavior Survey, Physician Executive Journal, November/December).

What about hospital-acquired infections? Only moderate progress has been made even though research has shown it's possible to almost eliminate them by following relatively simple procedures that have been widely published.

John Santa, MD, MPH, director of the Consumer Reports Health Ratings Center, identified the problem:

"For the process to work, each individual has to make a commitment to perform each step each time, and have the courage to correct their colleague when they see an error has been made." http://news.consumerreports.org/health/2011/06/teaching-hospitals-not-always-best-for-patient-safety.html

Dr. Santa hit the nail on the head. You can implement every technology and process known to medical science, but eliminating infection rates comes down to people. This is about behaviors and about culture. For instance, the traditional healthcare hiring process does nothing to assess a candidate's willingness or ability to "perform each step, each time" and to "have the courage to correct their colleague."

  • See our new whitepaper on developing hospital-wide behavioral competency models, which increase your ability to target candidates more likely to do the right things in these instances.
  • Join us in Denver, September 22-25, for the national ASHHRA Conference to learn more about the science of selection and its impact on outcomes.

Bryan Warren Bryan Warren was the former Director of Healthcare Solutions at PSI. He was responsible for developing and promoting tools and services designed specifically for the unique challenges faced by healthcare organizations.