Rosenstein Alan H
a 139 15th Avenue, San Francisco, CA 94118, USA.
Hosp Pract (1995). 2015;43(4):221-5. doi: 10.1080/21548331.2015.1083838. Epub 2015 Sep 2.
Disruptive behaviors continue to play a disturbing role in today's healthcare environment, negatively affecting care relationships that can adversely impact outcomes of patient care. Many organizations have implemented a number of different strategies in an effort to address this important issue with varying degrees of success. New complexities and changing roles, responsibilities and accountabilities for the delivery of appropriate, high-value, high-quality, safe, satisfying care have added increasing pressures on healthcare organizations to better integrate and coordinate healthcare delivery across the entire spectrum of care. Physicians play a crucial role in this process. When disruptive behaviors occur, rather than taking the traditional more remedial punitive approach to behavioral management, organizations would do better to try to focus on strategies that address physician and staff needs and provide appropriate supportive services to help them better adjust to stress and pressures of today's healthcare environment. Increasing levels of stress and burnout are taking their toll on physician attitudes and behaviors resulting in increasing levels of disillusionment, dissatisfaction and frustration affecting physician well-being and performance. Physicians often won't act on their own and we need to look to the organizations they are affiliated with to take the initiative by providing appropriate administrative, clinical and emotional support services before the occurrence of an unwanted event. Allowing physicians' input, listening to their concerns and providing needed support will enhance physician satisfaction, engagement, compliant attitudes and behaviors that lead to less disruption and better patient care.
在当今的医疗环境中，破坏性行为继续扮演着令人不安的角色，对护理关系产生负面影响，进而可能对患者护理结果产生不利影响。许多组织已经实施了多种不同策略，试图解决这一重要问题，但取得的成功程度各不相同。在提供恰当、高价值、高质量、安全且令人满意的护理方面，新的复杂性以及角色、责任和问责制的变化，给医疗组织带来了越来越大的压力，要求它们在整个护理范围内更好地整合和协调医疗服务的提供。医生在这一过程中起着关键作用。当出现破坏性行为时，组织不应采取传统的更具补救性的惩罚性行为管理方法，而应更好地专注于满足医生和员工需求的策略，并提供适当的支持服务，以帮助他们更好地适应当今医疗环境的压力。压力和职业倦怠程度的不断增加正在影响医生的态度和行为，导致幻灭感、不满和挫败感不断加剧，进而影响医生的幸福感和工作表现。医生通常不会自行采取行动，我们需要指望他们所属的组织主动在不良事件发生前提供适当的行政、临床和情感支持服务。听取医生的意见、倾听他们的担忧并提供所需支持，将提高医生的满意度、敬业度、合规态度和行为，从而减少干扰，改善患者护理。
