JOINT COMMISSION PROPOSES STANDARDS FOR DISRUPTIVE PHYSICIANS
JOINT COMMISSION PROPOSES STANDARDS FOR DISRUPTIVE PHYSICIANS
The Joint Commission (which has always been the informal name for the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and which will now be its formal name) has proposed disruptive behavior standards for Joint Commission accreditation, which it intends to apply in early 2007.
The new standard, LD.3.15, will state: “As a critical component of the culture of safety, leaders set expectations for behavior among those who work in the organization.” The new elements of performance will be as follows:
1. The leaders develop a code of conduct that applies to everyone who works in the organization.
2. The code of conduct defines desirable and disruptive behavior.
3. All who work in the organization are educated about both desirable and disruptive behaviors.
4. The leaders develop processes for managing disruptive behavior.
5. Leaders identify the rules of individual leadership groups in managing disruptive behavior.
6. The organized medical staff manages disruptive behavior exhibited by physicians or individuals who are granted clinical privileges.
7. Leaders establish a fair hearing process for those who exhibit disruptive behavior.
The policy is two fold. the organization will decide without physician input what constitutes disruptive conduct. this may include, at the organization's whim no competative actions or complaining about the poor care rendered. the discipline may be by the organization as defined in the policy and/or the medical executive committee which may be controlled by the organization with employed physicians or contracts. There are no standards what should or should not be in the policy. It is just up to the organization. Most current disruptive policies have in them a nexus with patient care. The new joint standard does not make this a necessary item. It is poorly thought out and is not part of the COPs. This is another way the joint is beholden to its payors, the organizations.
Does the JCAHO intend to require due process at said hearings?
Additional Response: I agree with Al Tobias. This is just an open invitation by Joint Commission to the hospitals to create another peer review weapon - when this situation is alrady being handled by existing peer review. Mike Cassidy
Does the JCAHO intend to require due process at said hearings?
Are US citizens free under JCAHO regulations to compare hospitals with regard to their safety gag-rules, by publishing without legal liability said rules on the internet so doctors can decide where it is safe for patients to be treated and for physicians to practice medicine? We all have a choice of hospitals. We are all patients.
Many "disruptive physicians" are inappropriately referred to psychiatrists or psychologists for an assessment and treatment.This is damaging to the physician(stigma associated with mental illness) and almost always irevelent to the issues of stress,anger,communication or emotional intelligence.
Since anger is not a pathological condition,psychotherapy or psychotropic medication is useless.
Anger is a problem when it is too intense,occurs too frequently,lasts too long or leads to person-directed aggression.Executive Coaching/anger Management is the intervention of choice.
I agree with Mr. Anderson. The literature and data on this topic supports more effective outcomes using remedial education that teaches emotional intelligence and leadership skills, followed up with executive coaching. The issues--in most cases--are related to EQ, stress, coping and communication---skill sets that can be learned. All of this inspired me to develop Inner Solutions for Success, an educational and consultating company that provides some of those services.