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Universal versus tailored solutions for alleviating disruptive behavior in hospitals.

Berman-Kishony T, Shvarts S - Isr J Health Policy Res (2015)

Bottom Line: These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools.Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents.Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

View Article: PubMed Central - PubMed

Affiliation: Ombudsperson, Department of Management, Rambam Medical Center, Haifa, Israel ; Visiting Research Fellow, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA USA.

ABSTRACT

Background: Disruptive behavior among hospital staff can negatively affect quality of care. Motivated by a standard on disruptive behavior issued by The Joint Commission (LD 3.10), as well as the desire to improve patient care, minimize liability, and improve staff retention, hospitals are setting policies to prevent and resolve disruptive behaviors. However, it is unknown whether uniform conflict management tools are equally effective among different hospital settings.

Methods: We surveyed residents and nurses to identify similarities and differences among hospital departments in the antecedents, characteristics, and outcomes of disruptive behaviors, and in the effectiveness of conflict management tools. We used a quantitative questionnaire-based assessment to examine conflict perceptions in eight different hospital departments at Rambam Medical Center in Haifa, Israel.

Results: Most participants (89 %) reported witnessing disruptive behavior either directly or in other parties; the most significant causes were identified as intense work, miscommunication, and problematic personalities. The forms of these behaviors, however, varied significantly between departments, with some more prone to expressed conflicts, while others were characterized by hidden disruptive behaviors. These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools. Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents. Other tools, however, are antecedent-specific, falling into two principal categories: tools directly removing a specific problem and tools that offer a way to circumvent the problem.

Conclusions: Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

No MeSH data available.


Related in: MedlinePlus

Correlation between effectiveness of Tools for alleviating disruptive behavior and the Antecedents of the conflict. Red color represents strong correlation between a specific antecedent and a specific tool for alleviating disruptive behavior. X’s signifies that the correlation is statistically significant (P value < 0.05). Some Tools are effective against many type of conflicts (vertical blocks), while others are effective only against specific type of conflicts (individually bolded squares)
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Fig6: Correlation between effectiveness of Tools for alleviating disruptive behavior and the Antecedents of the conflict. Red color represents strong correlation between a specific antecedent and a specific tool for alleviating disruptive behavior. X’s signifies that the correlation is statistically significant (P value < 0.05). Some Tools are effective against many type of conflicts (vertical blocks), while others are effective only against specific type of conflicts (individually bolded squares)

Mentions: All tools to address disruptive behavior were scored high with only mild variability in perceived effectiveness (Fig. 5). Participant responses regarding the effectiveness of potential solutions to alleviate disruptive behavior received uniformly high scores. To better understand possible differences in alleviating tools required for different circumstances, we analyzed the questionnaire data for correlations between suggested alleviating tools and the reported antecedents of disruptive behavior (Fig. 6). As seen in the figure, some tools are generally effective, while others are effective only for specific conflict antecedents. The generally effective tools include process for evaluating staff complaints and courses on teamwork and conflict management.Fig. 5


Universal versus tailored solutions for alleviating disruptive behavior in hospitals.

Berman-Kishony T, Shvarts S - Isr J Health Policy Res (2015)

Correlation between effectiveness of Tools for alleviating disruptive behavior and the Antecedents of the conflict. Red color represents strong correlation between a specific antecedent and a specific tool for alleviating disruptive behavior. X’s signifies that the correlation is statistically significant (P value < 0.05). Some Tools are effective against many type of conflicts (vertical blocks), while others are effective only against specific type of conflicts (individually bolded squares)
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4556051&req=5

Fig6: Correlation between effectiveness of Tools for alleviating disruptive behavior and the Antecedents of the conflict. Red color represents strong correlation between a specific antecedent and a specific tool for alleviating disruptive behavior. X’s signifies that the correlation is statistically significant (P value < 0.05). Some Tools are effective against many type of conflicts (vertical blocks), while others are effective only against specific type of conflicts (individually bolded squares)
Mentions: All tools to address disruptive behavior were scored high with only mild variability in perceived effectiveness (Fig. 5). Participant responses regarding the effectiveness of potential solutions to alleviate disruptive behavior received uniformly high scores. To better understand possible differences in alleviating tools required for different circumstances, we analyzed the questionnaire data for correlations between suggested alleviating tools and the reported antecedents of disruptive behavior (Fig. 6). As seen in the figure, some tools are generally effective, while others are effective only for specific conflict antecedents. The generally effective tools include process for evaluating staff complaints and courses on teamwork and conflict management.Fig. 5

Bottom Line: These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools.Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents.Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

View Article: PubMed Central - PubMed

Affiliation: Ombudsperson, Department of Management, Rambam Medical Center, Haifa, Israel ; Visiting Research Fellow, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA USA.

ABSTRACT

Background: Disruptive behavior among hospital staff can negatively affect quality of care. Motivated by a standard on disruptive behavior issued by The Joint Commission (LD 3.10), as well as the desire to improve patient care, minimize liability, and improve staff retention, hospitals are setting policies to prevent and resolve disruptive behaviors. However, it is unknown whether uniform conflict management tools are equally effective among different hospital settings.

Methods: We surveyed residents and nurses to identify similarities and differences among hospital departments in the antecedents, characteristics, and outcomes of disruptive behaviors, and in the effectiveness of conflict management tools. We used a quantitative questionnaire-based assessment to examine conflict perceptions in eight different hospital departments at Rambam Medical Center in Haifa, Israel.

Results: Most participants (89 %) reported witnessing disruptive behavior either directly or in other parties; the most significant causes were identified as intense work, miscommunication, and problematic personalities. The forms of these behaviors, however, varied significantly between departments, with some more prone to expressed conflicts, while others were characterized by hidden disruptive behaviors. These outcomes were correlated by the antecedents to disruptive behavior, which in turn affected the effectiveness of alleviating strategies and tools. Some tools, such as processes for evaluating complaints, teamwork and conflict management courses, and introducing a behavioral mission statement, are effective across many antecedents. Other tools, however, are antecedent-specific, falling into two principal categories: tools directly removing a specific problem and tools that offer a way to circumvent the problem.

Conclusions: Conflict resolution tools and strategies, based on residents and nurse perceptions, may be more effective if tailored to the specific situation, rather than using a "one-size-fits-all" approach.

No MeSH data available.


Related in: MedlinePlus