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Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.

Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.

Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.

Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.

Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.

Medical Staff Bylaws and Policies Should Address Disruptive Behavior to Promote Healthy Work Environments and Mitigate Risks

Disruptive behavior in healthcare settings diminishes employee morale and collegiality and negatively impacts patient safety and quality of care. The Joint Commission previously noted a significant breakdown in team communication resulting from poor behavior and identified a clear link between disruptive behavior and medical errors and other adverse patient events. (Sentinel Event Alert 40: Behaviors That Undermine a Culture of Safety, TJC, June 18, 2021.) The American Medical Association Code of Ethics defines disruptive behavior as “… any abusive conduct, including sexual or other forms of harassment, or forms of verbal or nonverbal conduct that harms or intimidates others to the extent that quality of care or patient safety could be compromised.”

Examples of disruptive behavior include sexual comments and gestures, racial or ethnic jokes, profanity, verbal outbursts, physical threats, throwing objects, undermining comments, name calling, and intimidating behavior. Disruptive behavior also includes passive activities, such as refusing to perform tasks or exhibiting unproductive attitudes during routine activities.

The best practice is to address disruptive behavior as soon as it is identified to prevent the behavior from escalating. In many cases, the provider may not realize that he or she is disruptive and can self-correct with conscious awareness.

Medical staff bylaws and policies should address disruptive behavior so that healthcare organizations and their medical staff leadership have a roadmap to proactively address concerning behavior before it evolves into an unhealthy or hostile environment and/or exposes the organization to potential risk.

According to the AMA Code of Medical Ethics, Opinion 9.4.4, policies or bylaws addressing disruptive behavior should:

  • Establish a body authorized to receive, review, and act on reports of disruptive behavior, such as a medical staff wellness committee. Members must be required to disclose relevant conflicts of interest and to recuse themselves from a hearing.
  • Establish procedural safeguards that protect due process.
  • Clearly state principal objectives in terms that ensure high standards of patient care, and promote a professional practice and work environment.
  • Clearly describe the behaviors or types of behavior that will prompt intervention.
  • Provide a channel for reporting and appropriately recording instances of disruptive behavior. A single incident may not warrant action, but individual reports may help identify a pattern that requires intervention.
  • Establish a process to review or verify reports of disruptive behavior.
  • Establish a process to notify a physician that his or her behavior has been reported as disruptive, and provide opportunity for the physician to respond to the report.
  • Provide for monitoring and assessing whether a physician’s disruptive conduct improves after intervention.
  • Provide for evaluative and corrective actions that are commensurate with the behavior, such as self-correction and structured rehabilitation. Suspending the individual’s responsibilities or privileges should be a mechanism of final resort.
  • Identify who will be involved in the various stages of the process, from reviewing reports to notifying physicians and monitoring conduct after intervention.
  • Provide clear guidelines for protecting confidentiality.
  • Ensure that individuals who report instances of disruptive behavior are appropriately protected.

Healthcare organizations should periodically review and update their bylaws, rules and regulations, and other governing documents. As a rule of thumb, medical staff bylaws should be reviewed every three to four years to ensure compliance with current standards and legal and practice developments.