6 Ways to Reduce Incivility in Health Care Settings
During the course of the COVID-19 pandemic, support and gratitude for health care providers has waned and, in many cases, been replaced by distrust and increasing aggression. And front line staff, including physicians, have been bearing the brunt of much angrier, frustrated and wearier patients and their families.
In fact, the American Psychiatric Association’s recent Stress in America report found that eight out of 10 Americans said the pandemic has created significant stress in their life. This stress and the growing emotional toll may be continuing to fuel what hospital and other health care providers are seeing.
Research shows that witnessing rudeness and similar bad behaviors in general interferes with our working memory and decreases performance. These types of disruptions can be catastrophic, as exposure to rudeness has been shown to negatively impact medical teams’ diagnoses and procedural performance. Physicians exposed to rudeness can get stuck on an initial incorrect diagnosis, leading to medical errors. All of this could ultimately increase mortality. In a study of more than 4,500 doctors and nurses, 71% saw a link between disruptive behavior (defined as “abusive personal conduct,” including condescending, insulting, or rude behavior) and medical errors, and 27% connected such behavior to actual deaths among their patients.
To protect both patients and frontline workers, health care leaders must do what they can to reduce incivility and bad behavior. The following 6 steps can help decrease hostility and protect providers and patients.
- Implement safety training
Global violence against health care workers in the workplace has increased during the pandemic. Establish a workplace violence committee, and launch online reporting of incidents and make programs like the Non-Abusive Psychological and Physical Intervention (NAPPI) training available for all caregivers. Widely used in health care, this training program focuses on de-escalation, self-protection, and restraint training.
- "Nudge" patients and caregivers
Nudges are short, personalized recommendations with a clear call-to-action. They have been found to be useful in a variety of settings, including health care.
- Reinforce expectations with training
Expectations set the tone. Through training and reinforcement, health care providers should be reminded of what they need to do in hostile situations, how to respectfully respond, and how to hold people accountable for their actions. "Do no harm" not only applies to patients, it also applies to the emotional impact of the workplace on the people who work within it.
- Meet people where they are
Simply recognizing that the pandemic has created trauma (not just medical, but also devastating psychological trauma, physical injury, and emotional harm) can support caregivers' growth and healing. Several tactics supplement trauma-informed care.
- Create recovery moments
The tactics above won't stop incivility entirely, so it's also important that you and your colleagues take care of yourselves in the face of bad behavior. For example, encourage other caregivers to take breaks when they can and promote self-awareness and gratitude.
- Find your tribe
Positive relationships inside and outside of work are paramount. Encourage colleagues to identify and call on those who energize them and lift their spirits. Banding together in teams or a community provides a more potent effect and increases others' success, just like caring for patients.
The full article from the American Association for Physician Leadership is available here.
|
