Approved by the Board of Governors Nov. 16, 2020.
Statement of the Issue
Healthcare executives have a professional and ethical responsibility to create and maintain an organizational culture that promotes quality patient care and a healthy work environment. Toward that goal, healthcare executives should establish policies that are designed to protect staff from inappropriate, disruptive and harmful behavior, including aggression, bias, harassment and intimidation. Healthcare executives also should provide staff with relevant education, training and support, which allows staff to identify and promptly report inappropriate and disruptive conduct.
An organizational culture that clearly prohibits inappropriate and disruptive behaviors while providing the necessary resources and mechanisms to safeguard against such behaviors can improve teamwork, foster a sense of mutual respect and improve communication. Not only can quality of care and patient safety be enhanced, but there is a concomitant reduction in the legal, physical and emotional repercussions of inappropriate and disruptive behaviors such as loss of productivity, absenteeism, turnover, low morale, lack of trust and communication breakdowns.
Policy Position
The American College of Healthcare Executives believes all healthcare executives have a professional and ethical responsibility to promote a healthy workplace that is free of aggression, harassment and intimidation, and where staff are protected from bias. Healthcare executives should commit to providing a work environment for staff that is free of inappropriate and disruptive behavior, including harassment on the basis of gender, sexual orientation, age, race, ethnicity, citizenship, religion, national origin, disability or any other personal characteristic. On behalf of their employing organizations, healthcare executives must further realize they often are responsible for implementing policies relating to workplace conduct and for monitoring compliance among their managers and physician employees. To this end, healthcare executives should model desired behaviors and promote multifaceted programs in their organizations to prevent inappropriate and disruptive behaviors.
Healthcare executives should also consult with legal counsel to develop effective policies to protect staff from inappropriate and disruptive behavior. Such policies typically include, but are not limited to, the following:
Clearly articulated code of conduct, workplace harassment and workplace violence policies that prohibit various types of inappropriate and disruptive behavior. Typically, such policies include a list of prohibited conduct, delineate methods for making and investigating complaints, state that retaliation is prohibited and no reprisals will be taken against any employee for filing a good-faith complaint under the organization’s policies and assure prompt and effective corrective action will be taken.
These policies should be revised on a periodic basis and incorporated into the employee handbook. Policies also should be expressed as expectations for all who work in and on behalf of organizations (i.e., clinical staff, volunteers, contract employees).
Employee training on inappropriate and disruptive behavior and its prevention. Human resources staff or other individuals who have a technical and legal understanding of the issues, in addition to demonstrated ability to stimulate discussion about this sensitive topic should conduct training. This typically should be conducted on an ongoing and regular basis with the goals of: raising awareness of bias, harassment, intimidation and aggression; clarifying misconceptions about what constitutes these behaviors; explaining the manager’s role and responsibility in providing a safe and supportive work environment; and sharing the specifics of the organization’s policy prohibiting inappropriate and disruptive behavior.
Workplace safety and quality of patient care are dependent on teamwork, communication and a collaborative work environment. To assure quality and to promote a culture of safety, healthcare executives must address the continuum of inappropriate behaviors that threaten overall performance and could impact patient outcomes.
Policy created: November 1996
Last revised: November 2015
References
American Medical Association's Opinion E-9.4.4
The Joint Commission Standard L.D. 03.01.01 (PDF)
The Joint Commission, Sentinel Event Alert, Issue 40