Physical and psychological abuse in Canadian operating rooms

Villafranca, Alexander; Hamlin, Colin; Jacobsohn, Eric

doi:10.1007/s12630-016-0777-9

Cited by 6 publications

(10 citation statements)

References 4 publications

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“…As the survey respondents represent only a small fraction of the OR workforce in North America, the actual number of abusive events in Canada and the United States is likely orders of magnitude greater. Given the negative effect of abusive behaviour on team-work, clinical decision-making, staff health, institutions, and patient outcomes, 1,[2][3][4][5][6][7][8][9][10][11][12][13][14][15] in addition to the negative psychologic implications this may have for individuals who frequently witness abusive behaviour, the results of this survey may be a cause for concern. It is difficult to compare the overall prevalence estimates with previous research since the studies measured different behaviours falling under the definition of ''abuse'' and often did not differentiate between abuse that was witnessed or personally experienced.…”

Section: Discussionmentioning

confidence: 99%

“…Secondly, this study is the largest to date, and unlike previous studies, it has respondents from most of the professions who work in the OR. 4,13,28,34,35 Lastly, exposure to abuse was characterized using numerous estimates of prevalence and frequency, thereby providing greater information about exposure.…”

Section: Discussionmentioning

confidence: 99%

“…1 In the operating room (OR), disruptive behaviour can interfere with communication, team-work, clinical decision-making, and technical performance, 1,2,3 and ultimately increase the risk of patient morbidity and mortality. 2,4,5 It can also negatively impact the psychologic and physical health of staff. [6][7][8][9][10][11][12][13][14] The effect on institutions includes decreased productivity, staff turnover, increased costs, and legal liability.…”

Section: Résumémentioning

confidence: 99%

“…In a previous communication that engendered significant public discourse, we reported that many Canadian OR clinicians were exposed to abusive behaviour over a twelve month period. 4,22,23 The current report details the prevalence of abusive behaviour in a larger sample of clinicians in both Canada and the United States, including clinicians from the initial pilot report. 4 It also provides a more extensive description of clinician exposure to abuse by differentiating between abuse that was experienced and abuse that was witnessed, and by describing the number of abusive events experienced by the group of respondents.…”

Section: Résumémentioning

confidence: 99%

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Abusive behaviour in Canadian and US operating rooms

Villafranca

Magid

Young

et al. 2019

Can J Anesth/J Can Anesth

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Background Disruptive intraoperative behaviour has detrimental effects on clinicians, institutions, and patients. Abusive behaviour is an egregious form of disruptive behaviour that has a particular risk of detrimental consequences. The prevalence of abusive behaviour in the operating room (OR) is uncertain. We therefore examined the prevalence and frequency of exposure to abusive behaviour in a cohort of Canadian and US OR clinicians. Methods This was a sub-study of an international survey examining disruptive behaviour in the OR. It included a cohort of clinicians from Canada and the United States who were recruited from six perioperative associations and two institutions. Clinicians were asked about their intraoperative exposure to three abusive behaviours: physical assault, verbal threats, and intimidating invasion of their personal space. From the responses, we derived the proportion of clinicians who experienced or witnessed abuse (i.e., prevalence) and the number of abusive events experienced by all respondents (i.e., frequency). Results Of the 7,465 clinicians who responded to the original international survey, 2,875 were part of this abuse Alexander Villafranca and Kirby Magid have contributed equally to the work.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

Section: Résumémentioning

confidence: 99%

See 2 more Smart Citations

Abusive behaviour in Canadian and US operating rooms

Villafranca

Magid

Young

et al. 2019

Can J Anesth/J Can Anesth

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“…The concept of professionalism has ethical behaviour at its core. Disruptive behaviour, outlined twice in this issue, 5,6 can result when professionalism is abrogated. Furthermore, burnout and other emotional exhaustion, as Dr. Yang highlights, can also increase our chances of callous (i.e., unprofessional) dealings toward patients.…”

mentioning

confidence: 99%

The physician at risk: disruptive behaviour, burnout, addiction, and suicide

Grocott

Bryson

2016

Can J Anesth/J Can Anesth

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Disruptive behaviour in the perioperative setting: a contemporary review

Villafranca

Hamlin

Enns

et al. 2016

Can J Anesth/J Can Anesth

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PurposeDisruptive behaviour, which we define as behaviour that does not show others an adequate level of respect and causes victims or witnesses to feel threatened, is a concern in the operating room. This review summarizes the current literature on disruptive behaviour as it applies to the perioperative domain.SourceSearches of MEDLINE®, Scopus™, and Google books identified articles and monographs of interest, with backreferencing used as a supplemental strategy.Principal findingsMuch of the data comes from studies outside the operating room and has significant methodological limitations. Disruptive behaviour has intrapersonal, interpersonal, and organizational causes. While fewer than 10% of clinicians display disruptive behaviour, up to 98% of clinicians report witnessing disruptive behaviour in the last year, 70% report being treated with incivility, and 36% report being bullied. This type of conduct can have many negative ramifications for clinicians, students, and institutions. Although the evidence regarding patient outcomes is primarily based on clinician perceptions, anecdotes, and expert opinion, this evidence supports the contention of an increase in morbidity and mortality. The plausible mechanism for this increase is social undermining of teamwork, communication, clinical decision-making, and technical performance. The behavioural responses of those who are exposed to such conduct can positively or adversely moderate the consequences of disruptive behaviour. All operating room professions are involved, with the rank order (from high to low) being surgeons, nurses, anesthesiologists, and “others”. The optimal approaches to the prevention and management of disruptive behaviour are uncertain, but they include preventative and professional development courses, training in soft skills and teamwork, institutional efforts to optimize the workplace, clinician contracts outlining the clinician’s (and institution’s) responsibilities, institutional policies that are monitored and enforced, regular performance feedback, and clinician coaching/remediation as required.ConclusionsDisruptive behaviour remains a part of operating room culture, with many associated deleterious effects. There is a widely accepted view that disruptive behaviour can lead to increased patient morbidity and mortality. This is mechanistically plausible, but more rigorous studies are required to confirm the effects and estimate their magnitude. An important measure that individual clinicians can take is to monitor and control their own behaviour, including their responses to disruptive behaviour.

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Physical and psychological abuse in Canadian operating rooms

Cited by 6 publications

References 4 publications

Abusive behaviour in Canadian and US operating rooms

Abusive behaviour in Canadian and US operating rooms

The physician at risk: disruptive behaviour, burnout, addiction, and suicide

Disruptive behaviour in the perioperative setting: a contemporary review

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