On July 9, 2008, the Joint Commission, a well-respected professional body tasked with accrediting US health care facilities, issued a new Sentinel Event Alert.  Unlike its usual fare of infection prevention guidelines and medication administration regulations, this alert ventured into new territory: caregivers' behavior.  According to a news report posted on the Joint Commission website, "Rude language and hostile behavior among health care professionals goes beyond being unpleasant and poses a serious threat to patient safety and the overall quality of care." 

In other words, the Joint Commission is telling us that it's time to shape up and behave ourselves.

While some health care workers may argue that the report places unnecessary attention on what should be an automatic expectation of civility in health care environments, others likely feel it is high time for the Joint Commission to address this touchy subject.  Surely, all of us can cite examples of situations in which patients, support staff, or family members were treated with demeaning, intimidating, or inappropriate behavior by hospital, clinic, or laboratory workers.  Further, most of us probably said nothing in response to these situations.  We seethed quietly, or shrugged our shoulders in acquiescent resignation.

But now the Joint Commission has come up with a strategy to deal with such cases.  Should a health care worker speak or act in a disrespectful manner on the job, written policies will map out, step-by-step, the consequences.  Well-defined codes of conduct that delineate acceptable versus unacceptable behavior will be drafted by each institution.  Subsequently, health care facilities will be required to create "a formal process for managing unacceptable behavior."  Standards must be in place by January 1, 2009 in all home health agencies, laboratories, ambulatory care facilities, and behavioral health care facilities seeking accreditation by the Joint Commission.

The Joint Commission stresses that the overwhelming majority of American health care providers are compassionate and professional.  However, it also believes that clear consequences must be in place when care givers are behave otherwise.  Patient health and safety is at stake, the Joint Commission president, Mark R. Chassin, states. 

How will hospitals and clinics institute the sort of cultural shift required by zero-tolerance-for-poor-behavior codes of conduct?  The Joint Commission makes several recommendations.  Those who deal with the general public should be trained in "being courteous during telephone interactions".  Those in leadership positions should be educated about the importance of modeling professional behavior.  Systems for reporting infractions and instituting disciplinary actions should be made clear to all employees.  And, finally, the Commission recommends "reducing fears of retribution against those who report intimidating and disruptive behaviors [or] empathizing with and apologizing to patients and families who are involved in or witness intimidating or disruptive behaviors."

Can the Joint Commission actually enforce compassion and sensitivity?  Only time will tell.  But I think most of us can agree that it is a step in the right direction. 

Reference:

Joint Commission Alert: Stop Bad Behavior among Health Care Professionals. (2008, July 9).  The Joint Commission News Releases.

Copyright 2008- American Society of Registered Nurses (ASRN.ORG)-All Rights Reserved