JCAHO Disruptive Physician Alert Offers Few Guidelines for Intervention

One glaring omission of the January 1, 2009 JCAHO Policy guideline for "disruptive behavior" in Health Care Organizations is the lack of recommended intervention to address the "Behaviors that undermine a culture of safety".

It is clear, however, that interventions should be designed to specifically address the behaviors that are defined in the Alert. In addition, education and skill-based training and coaching are referenced. Finally, "cultural assessment tools" are suggested to determine 'whether or not attitudes change over time'.

Here is an excerpt from the JCAHO Sentinel Alert:

"Educate all team members – both physicians and non-physician staff – on appropriate professional behavior defined by the organization’s code of conduct.The code and education should emphasize respect. Include training in basic business etiquette (particularly phone skills) and people skills. Provide skills-based training and coaching for all leaders and managers in relationship-building and collaborative practice, including skills for giving feedback on unprofessional behavior, and conflict resolution. Cultural assessment tools can also be used to measure whether or not attitudes change over time."

The first two programs designed to help "disruptive physicians" are the PACE Program at the University of California at San Diego, and the Distressed Physician Program at Vanderbilt University School of Medicine.

Both of these programs combine emotional intelligence and anger management to teach skill enhancement. Unfortunately, these programs are offered in a small group format rather than individual coaching, and are limited to participants who can travel to Nashville, Tennessee or San Diego, Ca. on a quarterly based. The total number of new participants seen per year is 32 for each program. These programs are already filled through 2009.

The Anderson & Anderson Executive Coaching/Anger Management Program is unique in a number of ways. The Anderson & Anderson coaching is an anger management program based on emotional intelligence. It includes a Pre- and Post-Test designed to determine the participants’ level of competence in recognizing and managing anger, recognizing and managing stress, primary and secondary styles of communication and empathy/emotional intelligence. The four domains of emotional intelligence are self-awareness, self-control, social-awareness and relationship-management.

Like the PACE Program and the Distressed Physician Program, the Anderson & Anderson Executive Coaching/Anger Management model were already being offered years before the JCAHO Sentinel Alert. This program is offered on-site, seven days a week at a location selected by the participant or in the Brentwood/Los Angeles office of Anderson & Anderson. It can be provided over a two-day 12 -hour period followed by twice monthly phone sessions over a six month period. Post-tests are given at three months and six months. For physicians who live in the locally near the Brentwood/Los Angeles office, the option of being seen two hours on a weekly basis for six weeks (for the initial twelve sessions) is available.

For information on the Anderson & Anderson Executive Coaching for Physicians Program, click here or call our office at 310-207-3591.

George Anderson, MSW, BCD, CAMF, CEAP
Diplomat, American Association of Anger Management Providers
Anderson & Anderson®, The Trusted Name in Anger Management
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