Journal Article

Improving employee voice about transgressive or disruptive behavior: a case study.

Dixon-Woods M; Campbell A; Martin G; Willars J; Tarrant C; Aveling EL; Sutcliffe K; Clements J; Carlstrom M; Pronovost P.

Disruptive and unprofessional behaviors are known threats to safety culture and contribute to burnout among health professionals. In response to an episode of serious misconduct by a clinician, an academic hospital implemented a structured effort to address disruptive behavior by developing mechanisms for frontline staff to voice their concerns. This article reports on the development and implementation of the effort, which focused on addressing longstanding aspects of institutional culture that were perceived as tolerating—and providing tacit endorsement of—prominent leaders who engaged in disruptive behavior.