There's an excellent blog post on the Virginia Mason Medical Center site: “Does respecting co-workers make patients safer?“
As a leader in adopting and adapting Toyota management methods to healthcare, Virginia Mason understands that “respect for people” is a core part of this philosophy (as I've recently blogged about). Respectful behavior is an active choice we make each and every day. Disrespectful attitudes and behavior can interfere with providing the best patient care.
They quote patient safety expert Dr. Lucian Leape:
“A substantial barrier to progress in patient safety is a dysfunctional culture rooted in widespread disrespect [including] … disruptive behavior; humiliating, demeaning treatment of nurses, residents, and students; passive-aggressive behavior; passive disrespect; dismissive treatment of patients; and systemic disrespect.”
They quote Leape as saying that these behaviors are a threat to patient safety and VMMC is working to replace these negative behaviors with positive, respectful behaviors. Their blog post describes a theatrical production was created to illustrate ten key behaviors, including:
- Listen to understand
- Share information
- Walk in their shoes
A key question in all of this is whether or not an organization can really influence the behavior of their employees and medical staff. From my experience, it helps to have senior leaders modeling behaviors they want to see through the rest of the organization. When the CEO stops “naming, blaming, and shaming” in response to errors or problems, leaders at lower levels see that it's OK to react that way themselves. But, can everybody change? Can enough people change?
See this related article from FierceHealthcare: Hospitals have had it with misbehaving docs.
One of the reasons hospitals are losing their tolerance for this behavior is guidance issued by The Joint Commission, warning hospitals that intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and adverse outcomes, increase the cost of care, and force medical personal to seek new positions.
“To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team,” The Join Commission wrote in the guidance.
Physician executive and Hospital Impact blogger Jonathan Burroughs, M.D., recounted an episode early in his career that illustrates the kinds of concerns communicated by The Joint Commission. After berating a nurse for not knowing what epinephrine and atropine were, Burroughs, upon reflection, concluded that his medical training had failed him in this situation, according to a Hospital Impact blog post. “Treating people with disrespect and shame will not improve human performance nor will it help patients to have better outcomes,” he wrote.
I hope hospitals have also had it with misbehaving executives and managers, as well! Disrespectful behavior from leaders is corrosive to an organization and a team environment… and this certainly impacts quality, safety, and other important factors in healthcare organizations (and any type of organization).
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