When clinicians report their coworkers' bad behavior, patient care improves

Physicians' and advanced practice professionals have the ability to undermine team function with disrespectful or unsafe conduct. A recent study in The Joint Commission Journal on Quality and Patient Safety says coworkers can help mitigate this problem by reporting such behavior.

The study was conducted at Vanderbilt University Medical Center in Nashville, Tenn. VUMC implemented methods for patients and families to encourage good physician behavior and promoted all healthcare team members — including faculty, residents and students — to use its occurrence reporting system.

Findings from the study showed most reports of disrespectful or unsafe conduct in the Co-Worker Observation Reporting System, or CORS, were submitted by nurses or physician colleagues. Additionally, 84 percent of the reports named physicians and advanced practice professionals for unprofessional conduct.

Since implementing CORS, 3 percent of medical staff members were associated with a pattern of CORS reports. Seventy-one percent of the staff who received pattern-related interventions to improve behavior were not named in any subsequent reports during the following year.

Ultimately, the authors of the study say monitoring documented coworker observations about unprofessional conduct systematically, and then sharing that information with the involved professionals, is a feasible approach to reducing incidents.

"This requires organizationwide implementation; coworkers willing and able to share respectful, nonjudgmental, timely feedback designed initially to encourage self-reflection; and leadership commitment to be more directive," according to a Joint Commission release on the study. "Follow-up surveillance also indicated that the majority of professionals 'self-regulate' after receiving CORS data. The lessons from this study will be very helpful for healthcare organizations that are striving to create a culture of safety."



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