Professionalism: a necessary ingredient in a culture of safety.

Disruptive and unprofessional behavior that goes unaddressed poses a threat to patient safety by hampering development of a culture of safety. This study reports on how one academic hospital addressed this issue by developing a multidisciplinary code of professionalism accompanied by a dedicated hotline for reporting unprofessional behavior. All reported incidents resulted in a combination of feedback, coaching, or disciplinary action for involved providers. Introduction of the code and the reporting system was associated with a significant improvement in teamwork and communication, as measured by the AHRQ Hospital Survey on Patient Safety Culture. This study provides an approach for health care organizations to address the disturbingly common problem of disrespectful and hostile behavior in the workplace. Other approaches are outlined in a PSNet perspective.