Disruptive physician behaviors and their impact on patient care in a health insurance hospital in Alexandria, Egypt

Elhoseny, Taghareed A.; Adel, Amr

doi:10.1097/01.epx.0000482793.51921.cb

Cited by 8 publications

(11 citation statements)

References 5 publications

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“…26 36 Some other situational factors investigated by a single study and contributing to incivilities in healthcare teams were fatigue, 44 personality conflicts, 24 the reason for the interaction, that is, request for medical investigations, 21 compensation or non-work-related factors. 60 on May 10, 2021 by guest. Protected by copyright.…”

Section: Situational Influences On Incivilitiesmentioning

confidence: 99%

Predictors and triggers of incivility within healthcare teams: a systematic review of the literature

et al. 2020

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ObjectivesTo explore predictors and triggers of incivility in medical teams, defined as behaviours that violate norms of respect but whose intent to harm is ambiguous.DesignSystematic literature review of quantitative and qualitative empirical studies.Data sourcesDatabase searches according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in Medline, CINHAL, PsychInfo, Web of Science and Embase up to January 2020.Eligibility criteriaOriginal empirical quantitative and qualitative studies focusing on predictors and triggers of incivilities in hospital healthcare teams, excluding psychiatric care.Data extraction and synthesisOf the 1397 publications screened, 53 were included (44 quantitative and 9 qualitative studies); publication date ranged from 2002 to January 2020.ResultsBased on the Medical Education Research Study Quality Instrument (MERSQI) scores, the quality of the quantitative studies were relatively low overall (mean MERSQI score of 9.93), but quality of studies increased with publication year (r=0.52; p<0.001). Initiators of incivility were consistently described as having a difficult personality, yet few studies investigated their other characteristics and motivations. Results were mostly inconsistent regarding individual characteristics of targets of incivilities (eg, age, gender, ethnicity), but less experienced healthcare professionals were more exposed to incivility. In most studies, participants reported experiencing incivilities mainly within their own professional discipline (eg, nurse to nurse) rather than across disciplines (eg, physician to nurse). Evidence of specific medical specialties particularly affected by incivility was poor, with surgery as one of the most cited uncivil specialties. Finally, situational and cultural predictors of higher incivility levels included high workload, communication or coordination issues, patient safety concerns, lack of support and poor leadership.ConclusionsAlthough a wide range of predictors and triggers of incivilities are reported in the literature, identifying characteristics of initiators and the targets of incivilities yielded inconsistent results. The use of diverse and high-quality methods is needed to explore the dynamic nature of situational and cultural triggers of incivility.

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Section: Situational Influences On Incivilitiesmentioning

confidence: 99%

Predictors and triggers of incivility within healthcare teams: a systematic review of the literature

et al. 2020

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“…Of these, two were eliminated because they were duplicates. After reading the titles and abstracts, and after reading the complete articles, 12 articles were selected for their systematic review [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ] ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 12 studies selected, five were conducted in the Unites States [ 20 , 23 , 26 , 28 , 29 ], 2 in Canada [ 22 , 30 ], two in Israel [ 27 , 31 ] and one each in other countries (China, Egypt and Iran) [ 21 , 24 , 25 ]. The studies included 22,176 health professionals (nurses, doctors, medicine students and technicians).…”

Section: Resultsmentioning

confidence: 99%

“…Different types of scales and questionnaires, validated and adapted to each studied population, were applied. Additionally, these were provided printed or virtually [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Starting with the results described in Table 1 , we found that disruptive behavior was frequently observed in the routines of the health professionals [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

“…Additionally, these were provided printed or virtually [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. Starting with the results described in Table 1 , we found that disruptive behavior was frequently observed in the routines of the health professionals [ 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 ]. With this respect, it was notable that most of the studies on the prevalence of disruptive behaviors in the hospital context could reach or exceed 90% of the occurrence in the last few weeks, months, or years [ 21 , 24 , 25 , 28 , 30 , 31 ].…”

Section: Resultsmentioning

confidence: 99%

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Disruptive Behavior at Hospitals and Factors Associated to Safer Care: A Systematic Review

et al. 2021

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Disruptive behavior creates a dysfunctional culture that has a negative impact on work relations and influences the quality of care and safety of the patient. The objective of the present work is to provide the best methodological quality scientific evidence available on disruptive behavior at a hospital, the aspect associated with the safety of the patient, and its impact on quality of care. For this, we included studies that addressed the prevalence of disruptive behaviors observed in the area of hospital health and its professionals. The selection, eligibility, data extraction and evaluation of the risk of bias stages were conducted by two researchers, and any discrepancies were solved by a third researcher. The data presented show that disruptive behaviors are frequently observed in the daily life of health professionals, and compromise the quality of care, the safety of the patient, and can lead to adverse effects. The results presented indicate that the appearance of disruptive behaviors compromises the quality of care, the safety of the patient, and the appearance of adverse effects, and can also affect the physical and mental health of the health professionals. PROSPERO registration number: CRD42021248798.

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Disruptive behavior in the operating room: Systemic over individual determinants

Campos

Lira

Mery

et al. 2022

International Journal of Surgery Open

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Background: The operating room (OR) environment presents specific conditions that put stress on work dynamics. Disruptive behavior among members of the health team is recognized to affect work dynamics and patient outcomes. As surgeons have been syndicated as frequent disruptors, the objective was to explore their perceptions about OR working dynamics and the occurrence of disruptive behavior. Study design: Qualitative exploratory study, based on semi-structured individual interviews. Twenty participants were sampled until data saturation. For better context, we also included in the sample anesthesiologists, nurses, and technicians, among others. Using grounded theory framework, investigators extracted data from verbatim transcriptions with qualitative software. Results: Problems of infrastructure, interpersonal relationships, and organizational failures had most density of citations and trigger the most disruptive behavior narrated events. Although personality traits were noted to promote some disruptive behavior occurrence, systemic determinants were critical, such as poorly defined working roles and a plethora of personal ways to cope or avoid disruptive behavior. Conclusion: Our results suggest that disruptive behavior events are not just a matter of a surgeon's personality traits but also substantiated by systemic normalization, informal communication strategies, and undefined roles, making teams less resilient to unexpected events. Graphical abstract Highlights

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Disruptive physician behaviors and their impact on patient care in a health insurance hospital in Alexandria, Egypt

Abstract: Disruptive physician behaviors are common in healthcare settings, with the most frequent behavior being refusal to cooperate with other providers. Training of physicians on team dynamics, communication skills, conflict management, and stress management is highly recommended.

Cited by 8 publications

References 5 publications

Predictors and triggers of incivility within healthcare teams: a systematic review of the literature

Predictors and triggers of incivility within healthcare teams: a systematic review of the literature

Disruptive Behavior at Hospitals and Factors Associated to Safer Care: A Systematic Review

Disruptive behavior in the operating room: Systemic over individual determinants

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