A program at a Tennessee healthcare system that encourages coworkers to report disrespectful and unsafe conduct by physicians and other advanced practice professionals has helped improve those behaviors, according to a new study.
The research, featured in the April issue of The Joint Commission Journal on Quality and Patient Safety, looked at Vanderbilt University Medical Center (VUMC) in Nashville, which put in place a Co-Worker Observation Reporting System (CORS) to address negative behaviors, such as ignoring established protocols.
The study cited the example of a surgeon who ignored a team member’s reminder that he should change his gown and gloves at a key point during the surgery in order to reduce infection rates.
The medical center developed the program after first using feedback from patients and families to promote changes in physician behavior. With its reporting system, which is available to all healthcare team members–including faculty, residents, and students–co-workers can report their concerns about physicians’ and advanced practice professionals’ disrespectful and unsafe conduct, which can undermine team function, according to a Joint Commission announcement about the study. Nurse and physician colleagues primarily reported concerns.
The study showed that 84 percent of the time, peer “messengers” shared CORS reports with physicians and other professionals who had at least one report made by coworkers. Since its start, 3 percent of medical staff had a pattern of CORS reports and 71 percent who received interventions were not named in any subsequent reports in a one-year follow-up period.
The authors concluded that monitoring coworkers’ observations about unprofessional conduct and sharing that information with those physicians and other professionals can work. “This requires organization-wide implementation; coworkers willing and able to share respectful, nonjudgmental, timely feedback designed initially to encourage self-reflection; and leadership commitment to be more directive,” the authors said.
The study found the majority of professionals are willing to correct their own behavior after receiving feedback from the CORS reports.
The VUMC program contrasts with the attitude of some hospitals that turn a blind eye to bad behavior by physicians, especially if they generate a lot of revenue, as our sister publication Fierce Healthcare reported.
There is a movement afoot in medicine to stop perpetuating a culture that tolerates bad behavior, as Fierce Practice Management previously reported. And while more ethics training and encouraging others to report bad behavior are part of the solution, healthcare must address the stress and burnout that can often lead to disruptive physician behavior.