Hospitals Face Challenges in Implementing the new Joint Commission (JCAHO) Standards

“Leaders create and implement a process for managing disruptive and inappropriate behaviors”.

Many healthcare organizations are encountering significant resistance to new standards for “disruptive physician behavior.” Here are some of the most typical areas of tension in drafting standards in this area:

• Mandated psychiatric assessments for physicians considered to exhibit “disruptive behavior.” This is by far the most contentious requirement. Physician groups fear the potential damages to physicians who are required to undergo a psychiatric or psychological assessment for a normal, human emotion gone temporarily awry. Angry/disruptive behavior is not defined as a nervous or mental disorder by any psychiatric or psychological paradigm; it is difficult to justify such a requirement.
• Pros and cons of reporting mandated physicians to Medical Quality Assurance/ Licensing Boards since interventions can be offered in-house or by programs designed for this purpose. Justifiably, physicians fear having this information become a part of data banks on physician competence.
• Listing doctors in the National Practitioner Data Bank can make finding a similar position at another hospital nearly impossible.
• Temporary loss of hospital privileges.
• Potential loss of patients and professional practices.
• Failure to offer intervention proactively as opposed to reactively.

As the Joint Commission has expanded the mandated interventions to all healthcare professionals and workers who demonstrate “disruptive and abusive” behaviors, mandating psychiatric assessments due to expressions of anger, stress or frustration may contribute to:

• Personnel shortages throughout all healthcare professions and industry
• Increased litigation and opening of HR records of accusers and accused alike
• Increased lawsuits by falsely accused offenders against healthcare organizations
• Further litigation against healthcare organizations for failure to control stress in the workplace

George Anderson, MSW, BCD, CAMF
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
http://www.andersonservices.com/
http://www.aaamp.org
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www.anger-management-resources.org