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There is a growing emphasis in healthcare on practices that keep patients safe from harm, medical errors, and preventable adverse events.

Most often we think of patient safety initiatives as efforts to reduce the risk of falls, infection, medication dosing errors, and so forth.

It is well known that safety and quality of patient care is dependent on teamwork, communication and a collaborative work environment (The Joint Commission, 2008).Disruptive behaviors include yelling and screaming, intimidating gestures, profane language, condescending comments, outbursts of anger, threats, retribution, and other such behaviors.(TJC Standard LD., EP 4, EP 5, effective January 1, 2009.) EP 4 states “The hospital/organization has a code of conduct that defines acceptable and disruptive and inappropriate behaviors.” EP 5 stipulates that “Leaders create and implement a process for managing disruptive and inappropriate behaviors.” These are the only TJC requirements actually effective January 1, 2009.TJC has said that it also will incorporate interpersonal skills and professionalism as part of the core competencies in the credentialing process.This new standard requires that institutions "have a code of conduct that defines acceptable and disruptive and inappropriate behaviors"; and that "leaders create and implement a process for managing disruptive and inappropriate behaviors." (The Joint Commission, 2008).

There is a growing focus on the role of prevailing hospital culture as a contributing factor in medical errors, and the healthcare industry has begun to realize that human interaction is an important source or error.These include: Because of their place in the hospital hierarchy, physicians have often been associated with disruptive behaviors, with nurses on the receiving end.But any category of healthcare worker can be involved in these acts, including pharmacists, nurses, administrators, and others.While we know that most healthcare workers perform their duties with care, compassion and professionalism, there are times when professionalism breaks down and can devolve into unprofessional behaviors.This can threaten patient safety, and therefore it is imperative that healthcare organizations take a stand by clearly identifying such behaviors and refusing to tolerate them.But the way healthcare professionals interact with each other is also an important factor—which is why collaborative care is an essential foundation to building a culture of safety.