Managing Bad Behavior in Healthcare

Behavior Management in Healthcare

Every organization has individuals who are more prone to producing conflict than others. ZIA can help identify problem points, set up a plan to resolve future conflicts, and help you prevent hiring toxic workers. Below is an article written by two of ZIA’s principals about managing bad behavior in healthcare.

Everyday Civility© in Healthcare: Evidence-Based Practices that Improve Patient Safety, Service, and Performance

Dr. Elizabeth Holloway and Dr. Mitchell Kusy

Zia Healthcare Consultants

“We’ve walked in your shoes.” OR “We make healthcare change happen”
OR “Your job is change management no matter what your job is.”

The Problem

There is strong evidence that society has become more uncivil. Consider that:
70-80% of medication errors are due to disruptive, bad behavior in healthcare1
• 51% nurses reported patient errors from physician abuse2
• 65% reported abuse from nurses; 77% from physicians3
• 50% claimed they could not handle incivility4
• 30.7% nurses quit as a result5: 51% of targets said they would likely leave as a result8
• Intimidation caused 49% of medication errors, resulting in 27% patient mortality6
• Only 1-6% of targets of incivility ever filed a formal complaint7
• 94% of leaders reported working with toxic people9 and were at a standstill as to how to handle it
• 92% rated the severity from 7 to 10 on a 10-point scale8
• 45% said the uncivil person lashed out 2-3 times per week8

1Schaefer, Helmreich, & Schedieggar (1994).
2Sofield & Salmond (2003).
3Rosenstein & O’Daniel (2008).
4Pearson, Anderson, & Portath (2009).
5Rosenstein & O’Daniel (2006).
6Institute Safe Medication Practices (2008).
7Cortina & Magley (2008).
8Holloway & Kusy (2010).
9Amabile & Kramer (2011).

The Solutions

We offer a menu of options for improving organizational performance.

1. Large-Scale Organizational Actions
• Board development to align organizational strategies
• Large-scale, real-time culture change
• A CIVIL Model© that puts power behind respect
• 4-phased due process with behavioral anchors
• 70%-30% task-values performance management split
2. Team Actions
• New recruiting practices with performance results
• Identification of toxic protectors and toxic buffers
• Templates for translating values into concrete team norms
• 4-step apology that models authenticity and respect
• Innovative team assessment for systemic change

3. Individual Actions
• 5-step TOTAL© feedback model to address incivility
• Values integration in performance discussions
• Progress Principle9 for incremental, sustainable change

The Results

Zia provides measurable results using evidence-based practices.
The 2009 Joint Commission Accreditation Standards for Hospitals has
mandated that hospitals have a process for dealing with “bad behavior in healthcare that
undermines a culture of safety.” We help you achieve this and more:
• Increased patient safety
• Increased staff satisfaction, commitment, & trust
• Increased engagement with physicians, staff, and leaders
• Increased bottom line
• Decreased medication errors

• Decreased turnover & absenteeism
“The day this person left our company is considered an annual holiday!”
(Quoted from our national research study of 400 leaders on toxic, bad behavior in healthcare. From our book: Toxic Workplace! Managing Toxic Personalities and Their Systems of Power.

“Blend of theory and practical actions…tools I can take back to my role…relevant to current work challenges…a dynamic presentation back and forth…engaging speakers with recent expertise and research…their playful, natural ease of collaboration was wonderful to watch, feel, enjoy.” Responses, American College of Healthcare Executives

“Best session in our leadership series…fantastic speakers…outstanding in how to renew team’s core values, manage conflict… very practical.” Responses, Physician Leader Program, metropolitan university-based medical school


Dr. Mitchell Kusy

Dr. Mitchell Kusy, a Fulbright Scholar in International Organization Development and professor at Antioch University, professor at Antioch University, Ph.D. Program in Leadership & Change, was head of leadership development for American Express and director of organization development at HealthPartners. Author of several business books, he consults in strategic planning, organization development, and the design of organizational communities of respectful engagement. He received the Minnesota Organization Development Practitioner of the Year Award in 1998. Dr. Kusy is a principal in his consulting firm and may be reached via email at mitchellkusy@gmail.com or his websiteat www.mitchellkusy.com.

Dr. Elizabeth Holloway

Dr. Elizabeth Holloway, a Fellow of the American Psychological Association and Diplomate in Professional Psychology, is a professor at Antioch University, Ph.D. Program in Leadership & Change. She was a Leadership Fellow at the University of Wisconsin-Madison and consults with leaders worldwide on systems approaches to supervision, mentoring, coaching, toxicity, and building communities of respectful engagement. She has published extensively in research and training of supervision in professional practice and incivility in at work. Dr. Holloway may be reached at elizabethlholloway@gmail.com or visit www.elizabethholloway.com

“From the beginning of the presentation to the end, I found myself nodding in agreement. Mitch and Elizabeth don’t
rely on anecdotes, but build their premises and conclusions on solid research and data. They are also both excellent
presenters, segueing from one section to the next and from each other with ease, polish, and professionalism.
Anyone attending their presentations will come away with the confidence and information to handle one of
management’s thorniest problems.” Response, Sr. Vice President

Is it time to deal with some toxic behavior?

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