A recent report released by the Pennsylvania Patient Safety Authority (PPSA) cites broadly defined "disruptive behavior" as a factor that could negatively affect patient safety. The PPSA study surveyed health care facilities around the state for more than two and a half years, looking for behaviors and incidents that could cause caregivers to make mistakes.
The study cites 177 incidents of disruptive, intimidating or careless behavior including:
- An angry surgeon leaving an operation before it was completed.
- Doctors and nurses dropping medical equipment on the floor and immediately using the un-sanitized instruments on patients (even in situations where replacement instruments were offered).
- Nurses having to call for clarification of written orders, thus delaying treatment and possibly angering the treating physician.
In addition, the study confirmed what many health care administrators and patient advocates already knew: the historically strained and difficult relationship between doctors and nurses or other employees continues. The traditional hospital hierarchy which places nurses and fellow staff members in a seemingly subservient role also plays a role in patient safety. Nurses may be reluctant to seek clarification from domineering doctors (even when further instruction is clearly in a patient's best interests); lower-level employees like lab techs or aides may fear retribution if they point out disruptive behaviors of their superiors; and a history of ignoring previous grievances will likely discourage new ones from being reported.
To avoid hospital errors and patient endangerment, the PPSA proffers a solution: health care facilities must foster a culture of cooperation, respect and openness, allowing the free expression of complaints and suggestions for improvement.