Universal versus tailored solutions for alleviating disruptive behavior in hospitals

Area of Science:

• Healthcare Management
• Organizational Behavior
• Medical Education

Background:

• Disruptive behavior among hospital staff impacts patient care quality, liability, and staff retention.
• Hospitals are implementing policies to address disruptive behavior, prompted by regulatory standards.
• The effectiveness of uniform conflict management tools across diverse hospital settings is not well understood.

Purpose of the Study:

• To identify similarities and differences in disruptive behaviors across hospital departments.
• To assess the effectiveness of various conflict management tools in different hospital settings.
• To understand the antecedents, characteristics, and outcomes of disruptive behaviors from staff perspectives.

Main Methods:

• A quantitative, questionnaire-based survey was administered to residents and nurses.
• Eight hospital departments at Rambam Medical Center were included in the study.
• The assessment examined conflict perceptions, including antecedents, characteristics, outcomes, and tool effectiveness.

Main Results:

• 89% of participants reported witnessing disruptive behavior, primarily caused by intense work, miscommunication, and personality issues.
• The manifestation of disruptive behaviors differed significantly across departments, ranging from expressed to hidden conflicts.
• While some tools (e.g., complaint evaluation, teamwork courses) were broadly effective, others were antecedent-specific.

Conclusions:

• Conflict resolution strategies are perceived by residents and nurses to be more effective when tailored to specific situational antecedents.
• A "one-size-fits-all" approach to conflict management in hospitals may be less effective than customized interventions.
• Understanding departmental variations in disruptive behavior is crucial for selecting appropriate resolution tools.