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PSNet: Patient Safety Network
Sentinel Event Alerts

Behaviors that undermine a culture of safety.

Sentinel event alert. 2008:1-3.

The Joint Commission issues sentinel event alerts one to two times yearly to highlight areas of high risk and to promote the rapid adoption of risk reduction strategies. Adherence to these strategies is then assessed on Joint Commission site visits at health care organizations nationwide. This newly released sentinel event alert focuses on intimidating and disruptive behaviors and the role they play in the costs, quality, safety, and satisfaction of care delivered. The alert outlines existing Joint Commission requirements and provides a series of suggested actions that include educational programs, "zero tolerance" policies, and clear processes for detecting, reporting, and documenting all instances of such unacceptable behavior.