When a Cup of Coffee is Not Enough: Equipping and Supporting Physician Leaders in Addressing Unprofessional Behaviors in Clinical Team Members

Description: Professionals commit to model compassion, respect, and display cognitive and technical competence. They also have a duty to engage in self and group-regulation.

Medicine is stressful, and professionals are subject to slips in performance. Most recognize their lapses and respond appropriately. That said, 2-8% of doctors model behaviors that threaten teamwork and contribute to avoidable surgical and medical complications and excessive malpractice claims.

The Vanderbilt Center for Patient and Professional Advocacy (CPPA) was established to support professionalism and deliver safe, high-quality care. CPPA’s work involves two programs, the Patient Advocacy Reporting System (PARS®), that uses unsolicited patient stories and the Co-worker Observation Reporting System (CORS) that uses co-worker safety reports to reliably identify and intervene to support team members who model disrespect.

This session will include review of 20+ years of CPPA experience, including the results of 3,400+ interventions conducted by trained peer messengers. While most recipients (85%) responded to feedback, a small number (446) were unwilling or unable. The session focus will shift to lessons learned supporting leaders in recognizing when to advance to authority-directed interventions, sources of authority to act, and resources to support appropriate evaluation, treatment/remediation, and as possible, return to work. The session will share how to deliver a leader’s directive message and address the occasional wrench when a non-responder asserts their “special” status to others.

Citations and Literature References (if none, write n/a): Hickson, Gerald et al., Balancing systems and individual accountability in a safety culture. From the Front Office to the Front Line: Essential Issues for Healthcare Leaders. (2012) 1-36.

Webb LE et al., Using Coworker Observations to Promote Accountability for Disrespectful and Unsafe Behaviors by Physicians and Advanced Practice Professionals. Jt Comm J Qual Patient Saf. 2016 Apr;42(4):149-64.

Cooper WO et al., Association of Coworker Reports About Unprofessional Behavior by Surgeons with Surgical Complications in Their Patients. JAMA Surg. 2019 Sep 1;154(9):828-834.

Dmochowski RR et al., Professionalism, Leadership, and a Pilfered Apple. Jt Comm J Qual Patient Saf. 2022 Aug;48(8):419-423.