Stopping bad behavior among professionals.

• Position: Health Care Personnel

Health care is a high-stakes, pressure-packed environment that can test the limits of civility in the workplace. An alert issued by The Joint Commission, Oakbrook Terrace, Ill., warns that rude language and hostile behavior among health care professionals goes beyond being unpleasant and poses a serious threat to patient safety and the overall quality of care.

Intimidating and disruptive behaviors are such a serious issue that The Joint Commission, an independent, not-for-profit organization that accredits and certifies more than 15,000 health care organizations and programs, is introducing new standards requiring the creation of a code of conduct that defines acceptable and unacceptable behaviors and a formal process for managing unacceptable behavior. The new standards take effect Jan. 1, 2009, for hospitals, nursing homes, home health agencies, laboratories, ambulatory care locales, and behavioral health care facilities across the U.S.

Verbal outbursts, condescending attitudes, refusing to take part in assigned duties, and physical threats all create breakdowns in the teamwork, communication, and collaboration necessary to deliver patient care. The Institute for Safe Medication Practices, Horsham, Pa., found that 40% of clinicians have kept quiet or remained passive during patient care events rather than question a known intimidator. To help end once-accepted behaviors that put patients at risk, The Joint Commission urges health care organizations to take action.

"Most health care workers do their jobs with care, compassion, and professionalism, but sometimes professionalism breaks down and caregivers engage in behaviors that threaten patient safety," says Mark R. Chassin, president of The Joint Commission. "It is important for organizations to take a stand by clearly identifying such behaviors and refusing to tolerate them."

To help put an end to intimidating and disruptive behaviors among...