Disruptive behavior in obstetrics: a hidden threat to patient safety

Veltman, Larry

doi:10.1016/j.ajog.2007.03.011

Cited by 43 publications

(22 citation statements)

References 9 publications

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“…For example, high acuity and high stress patient care areas such as the OR, emergency department (ED), labor and delivery, and ICUs are fraught with tales of bad behavior from healthcare providers. [681213] The current study found a statistically higher incidence of witnessed disruptive behaviors in different hospital locations; the highest were the ICU and ER, followed in descending order by the OR, and the “floor.”…”

Section: Discussionmentioning

confidence: 63%

Analysis of inter-provider conflicts among healthcare providers

Stecker¹,

Epstein²,

Stecker³

2013

Surg Neurol Int

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Background:Patient safety is a top priority of healthcare organizations. The Joint Commission (TJC) is now requiring that healthcare organizations promulgate polices to investigate and resolve disruptive behavior among employees.Methods:Our aims in this investigation utilizing the Provider Conflict Questionnaire (PCQ: Appendix A) included; determining what conflicts exist among a large sample of healthcare providers, how to assess the extent and frequency of disruptive behaviors, and what types of consequences result from these conflicts. The PCQ was distributed utilizing electronic postings, and predetermined e-mail lists to nurses and physicians across the US.Results:The convenience sample included 617 respondents to the questionnaire. All incomplete responses (failure to answer all 17 items on the questionnaire) were excluded from data analysis. Our major finding was that disruptive behavior was the greatest problem observed in 82% of organizations; 74% personally witnessed these behaviors, while 5% personally experienced these behaviors. Friedman analysis of variance (ANOVA) analyses demonstrated that the difference between these three estimates were significant (χ2 = 207.8 df = 2, P < 0.0001).Conclusion:Healthcare organizations in the US are bound by TJC regulations to develop leadership standards that address disruptive behavior. These organizations can no longer stand by and ignore behaviors that threaten not only the bottom line of the institution, but also most critically, patient safety. As more attention is being paid to recommendations and mandates from the TJC and the Institute of Medicine (IOM), we will need more data, like those provided from this study, to better document how to address, resolve, and prevent future “misbehaviors”.

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Section: Discussionmentioning

confidence: 63%

Analysis of inter-provider conflicts among healthcare providers

Stecker¹,

Epstein²,

Stecker³

2013

Surg Neurol Int

View full text Add to dashboard Cite

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“…Regarding the type of study, there was a predominance of articles of theoretical reflection (24), and updates (21), followed by analytical and cross-sectional studies (14), qualitative studies (4), experience reports (3), research intervention/evaluation (2), systematic review (1) and a case study (1). This is more data that reveals the need for refining the concept.…”

Section: Resultsmentioning

confidence: 99%

Analyzing the concept of disruptive behavior in healthcare work: an integrative review*

Oliveira

Silva

Guedes

et al. 2016

Rev. esc. enferm. USP

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Objective:To analyze the concept of disruptive behavior in healthcare work. Method: An integrative review carried out in the theoretical phase of a qualitative research substantiated by the theoretical framework of the Hybrid Model of Concept Development. The search for articles was conducted in the CINAHL, LILACS, PsycINFO, PubMed and SciVerse Scopus databases in 2013. Results: 70 scientific articles answered the guiding question and lead to attributes of disruptive behavior, being: incivility, psychological violence and physical/sexual violence; with their main antecedents (intrapersonal, interpersonal and organizational) being: personality characteristics, stress and work overload; and consequences of: workers' moral/mental distress, compromised patient safety, labor loss, and disruption of communication, collaboration and teamwork. Conclusion: Analysis of the disruptive behavior concept in healthcare work showed a construct in its theoretical stage that encompasses different disrespectful conduct adopted by health workers in the hospital context, which deserve the attention of leadership for better recognition and proper handling of cases and their consequences.

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“…3,[9][10][11] The resulting instrument was reviewed by a panel of expert colleagues to establish face validity. It was then edited by the authors and piloted in a series of focus groups with 18 trainees and attendings.…”

Section: Survey Instrument and Administrationmentioning

confidence: 99%

Interns' Experiences of Disruptive Behavior in an Academic Medical Center

Mullan¹,

Shapiro

McMahon

2013

Journal of Graduate Medical Education

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Background The first year of graduate medical education is an important period in the professional development of physicians. Disruptive behavior interferes with safe and effective clinical practice. Objective To determine the frequency and nature of disruptive behavior perceived by interns and attending physicians in a teaching hospital environment. Method All 516 interns at Partners HealthCare (Boston, MA) during the 2010 and 2011 academic years were eligible to complete an anonymous questionnaire. A convenience nonrandom sample of 40 attending physicians also participated. Results A total of 394 of 516 eligible interns (76.4%) participated. Attendings and interns each reported that their team members generally behaved professionally (87.5% versus 80.4%, respectively). A significantly greater proportion of attendings than interns felt respected at work (90.0% versus 71.5% respectively; P = .01). Disruptive behavior was experienced by 93% of interns; 54% reported that they experienced it once a month or more. Interns reported disruptive behavior significantly more frequently than attending physicians, including increased reports of condescending behavior (odds ratio [OR], 5.46 for interns compared with attendings; P < .001), exclusion from decision making (OR, 6.97; P < .001), and berating (OR, 4.84; P = .02). Inappropriate jokes, abusive language, and gender bias were also reported, and they were not significantly more frequent among interns than attending physicians. Interns most frequently identified nurses as the source of disruption, and were significantly more likely than faculty to identify nurses as the source of disruptive behavior (OR, 10.40; P < .001). Attendings reported other physicians as the most frequent source of disruption. Conclusions Although interns generally feel respected at work, they frequently experience disruptive behavior. Interns described more disruptive behaviors than a convenience sample of attending physicians at our institution.

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Disruptive behavior in obstetrics: a hidden threat to patient safety

Cited by 43 publications

References 9 publications

Analysis of inter-provider conflicts among healthcare providers

Analysis of inter-provider conflicts among healthcare providers

Analyzing the concept of disruptive behavior in healthcare work: an integrative review*

Interns' Experiences of Disruptive Behavior in an Academic Medical Center

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