Health care risk managers' consensus on the management of inappropriate behaviors among hospital staff

Abstract

Medical errors are the third-leading cause of death in the United States. One of the problems is timely recognition and management of inappropriate health care worker behaviors that lead to intimidation and loss of staff focus, eventually leading to errors. The purpose of this qualitative modified Delphi study was to seek consensus among a panel of experts in hospital risk management practices on the practical methods for early detection of inappropriate behaviors among hospital staff, which may be used by hospital managers to considerably mitigate the risk of medical mishaps. High reliability theory guided the research process, utilizing the conceptual framework of the fair and just culture patient safety model. A single research question asked what level of consensus exists among hospital risk management experts as to the practical methods for early detection of inappropriate behavior among hospital staff, which managers may use to ultimately mitigate the risk of preventable medical mishaps. This study included nonprobability purposive sampling (n = 34) and three rounds of questionnaires. Consensus was reached on 8 factors: setting expectations, developing a culture of respect, holding staff accountable, enforcing a zero-tolerance policy, confidentiality of reporting, communicating expected behavior, open communication, and investigating inappropriate behaviors.

Managing interpersonal conflict

“…3,4 Despite the prevalence of incivility and interpersonal conflict, nurse leaders are challenged to recognize and address negative behaviors in a timely manner. 8 In addition, nurse leaders may unwittingly contribute to patterns of poor performance by not holding employees to a consistent standard, making excuses for difficult employees and situations, and hoping that the problem will resolve itself. 7…”

Vaccine reluctance threat to global health

“…This issue of the Journal provides a variety of risk management problems and solutions, including an article featured for ASHRM continuing education credit discussing health care risk managers' consensus on the management of inappropriate behaviors among hospital staff. 4 The other articles in this issue present timely learning opportunities, including using medicolegal data to support safe medical care as part of a contributing factor coding framework 5 and TeamSTEPPS, an evidence-based approach to reduce clinical errors threatening safety in outpatient settings. 6 This issue also explores the impact of teamwork improvement training on communication and teamwork climate in ambulatory reproductive health care, 7 as well as an update on case law.…”