Why We Need a Single Definition of Disruptive Behavior

Abstract

Disruptive behavior is known to produce a wide range of negative effects in healthcare, such as impacting patient safety, lowering employee morale, and decreasing employee retention. Healthcare organizations have worked towards eliminating disruptive behavior; however, despite countless interventions, the issue continues to be a problem today. Why then does the issue of disruptive behavior persist? We argue that one reason is the multiple ways disruptive behavior can be described, henceforth defined as the "plurality of terms", which can make it difficult to collect relevant data by doing a simple literature search. Hence, we believe having a single definition for “disruptive behavior” will improve the meta-analysis on disruptive behavior research.

Physician Disruptive Behavior Compromising Safe Care Delivery

“…On the other hand, in a recent comprehensive review that included 163 relevant articles, over 200 unique terms were identified that describe disruptive behavior. 23 In an effort to provide more specificity, some professional organizations, like the College of Physicians and Surgeons of Ontario/Ontario Hospital Association, offer a list of behaviors that can be disruptive. 15 Disrespect, demeaning comments, placing blame on others for negative outcomes, intimidation, and failure to follow the generally accepted practice standards are a few examples of physician disruptive behavior relevant to the incidents presented here.…”

The Successful Anesthesia Patient Safety Officer

“…The term now encompasses a wide range of behavior from the overt (threatened or actual physical or verbal violence) to the more subtle (passive aggression, impatience, eye-rolling, or other nonverbal acts), and has also expanded to include health care professionals in any role. 16 Perhaps the most important advancement in its evolution will be the abandonment of the term "disruptive behavior" altogether, replacing it with the more accurate and comprehensive term "behaviors that undermine a culture of safety," as a Joint Commission Sentinel Event Alert was titled more than a decade ago. 17 These behaviors not only contribute to poor patient satisfaction, they decrease morale and increase staff turnover.…”

“…18 In addition to behavior that impedes psychological safety, definitions of disruptive behavior also include refusal to participate and comply with assigned tasks, policies, and procedures. 16,17 An anesthesiologist who declines to participate in a preincision timeout may fall into this categorization. When this circumstance occurs, failure to understand and address the social and psychological barriers involved in implementing the process must be considered.…”

Development of a Psychological Scale for Measuring Disruptive Clinician Behavior

“…Other studies included job-related categories such as harassment and passive-aggressive behavior. [15][16][17][18][19] These studies highlighted that the conceptual range of disruptive behavior was not constant. In addition, a threat was often categorized as psychological aggression 8,15,17 and as bullying/harassment.…”

“…In addition to incivility and violence, psychological aggression is generally used as a category of disruptive behavior. Other studies included job-related categories such as harassment and passive-aggressive behavior 15–19 . These studies highlighted that the conceptual range of disruptive behavior was not constant.…”