Holloway Elizabeth, Kusy Mitchell
Antioch University, Yellow Springs, OH, USA.
Adv Health Care Manag. 2011;10:239-65. doi: 10.1108/s1474-8231(2011)0000010020.
In response to the growing evidence that disruptive behaviors within health-care teams constitute a major threat to the quality of care, the Joint Commission on Accreditation of Healthcare Organization (JCAHO; Joint Commission Resources, 2008) has a new leadership standard that addresses disruptive and inappropriate behaviors effective January 1, 2009. For professionals who work in human resources and organization development, these standards represent a clarion call to design and implement evidence-based interventions to create health-care communities of respectful engagement that have zero tolerance for disruptive, uncivil, and intimidating behaviors by any professional. In this chapter, we will build an evidence-based argument that sustainable change must include organizational, team, and individual strategies across all professionals in the organization. We will then describe an intervention model--Toxic Organization Change System--that has emerged from our own research on toxic behaviors in the workplace (Kusy & Holloway, 2009) and provide examples of specific strategies that we have used to prevent and ameliorate toxic cultures.
鉴于越来越多的证据表明，医疗团队中的破坏性行为对医疗质量构成重大威胁，医疗组织认证联合委员会（JCAHO；联合委员会资源，2008年）制定了一项新的领导力标准，自2009年1月1日起，该标准将处理破坏性行为和不当行为。对于从事人力资源和组织发展工作的专业人员而言，这些标准是一个清晰的信号，要求他们设计并实施基于证据的干预措施，以营造一个相互尊重的医疗社区，对任何专业人员的破坏、不文明和恐吓行为零容忍。在本章中，我们将构建一个基于证据的论点，即可持续变革必须涵盖组织内所有专业人员的组织、团队和个人策略。然后，我们将描述一种干预模式——有毒组织变革系统，这是我们基于自身对工作场所有毒行为的研究（库西和霍洛韦，2009年）而形成的，并提供我们用于预防和改善有毒文化的具体策略示例。
