Avesar M, Erez A, Essakow J, et al. Diagnosis (Berl). 2021;8:358-367.
Disruptive and rude behavior can hinder teamwork and diminish patient safety. This randomized, simulation-based study including attendings, fellows, and residents explored whether rudeness during handoff affects the likelihood for challenging a diagnostic error. The authors found that rudeness may disproportionally hinder diagnostic performance among less experienced physicians.
The COVID-19 pandemic has dramatically affected the psychological and emotional well-being of health care workers. This article summarizes the COVID-19-related psychological effects on healthcare workers and the detrimental impact on team effectiveness. The authors recommended actions to mitigate the effects of stress on team performance and patient outcomes and discuss how teams can recover and learn from the current crisis to prepare for future challenges.
Cho H, Pavek K, Steege LM. J Nurs Manag. 2020;28:1250-1258.
This article reports results of a national survey of early-career hospital nurses exploring the relationship between verbal abuse experience (perpetrated by patients, family, physicians, and other staff) and nurse-reported patient care quality and safety outcomes. Verbal abuse experience differed by nurse gender and age. Nurses who experienced verbal abuse were less likely to report high-quality care and favorable safety grade and were less likely to report safety problems. Organizations should provide education to recognize and respond to nurses’ verbal abuse experiences.
Fasano HT, McCarter MSJ, Simonis JM, et al. Simul Healthc. 2021;6:85-91.
This study explored disparities in physician decision making among patients of varying socioeconomic status (SES) during simulated scenarios. While quantitative analyses did not identify a significant relationship between SES and image or medication ordering, patient-perceived empathy, or clinical performance, qualitative analyses identified three themes which may bias decision making – overt diagnostic focus, discharge planning, and risk and exposure.
Unprofessional behavior can hinder patient safety and create a disruptive work environment. Encompassing both qualitative and quantitative literature, this systematic review explored predictors and triggers of incivility in medical teams (defined as disrespectful behaviors but whose intent to harm is ambiguous). The review identified a wide range of triggers of incivility. Studies generally found that incivility occurs mainly within professional disciplines rather than across disciplines (e.g., physician to nurse) and surgery was the most commonly cited uncivil specialty. Situational and cultural triggers for incivility included excessive workload, communication issues, patient safety concerns, lack or support, and poor leadership.
Fargen KM, Drolet BC, Philibert I. Acad Med. 2016;91:858-64.
Disruptive and unprofessional behavior results in a poor culture of safety and may contribute to adverse events. This literature review sought to examine the incidence and types of unprofessional behaviors among medical students and residents. Although many studies show that trainees commit professionalism violations fairly regularly—for example, multiple studies show that up to 50% of residents falsify their duty hours—there was no clear evidence of an increase over time. The authors acknowledge that study of this area is impaired by lack of a standard definition and measurement strategy for unprofessional behavior and by a poor understanding of the relationship between professionalism violations and patient safety.
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