Crucial conversations: the most potent force for eliminating disruptive behavior.

The Joint Commission announced this year that rude language and hostile behavior pose serious threats to patient safety and quality of care. The Silence Kills study, conducted by VitalSmarts and the American Association of Critical-Care Nurses, reveals that more than three-fourths of caregivers regularly work with doctors or nurses who are condescending, insulting, or rude. Although such disruptive and disrespectful behavior can be hurtful, what prompted the Joint Commission to address them as a condition of accreditation is the mounting evidence that such behavior is also harmful. The study found that more than 20% of health professionals have seen actual harm come to patients as a result of such behavior. The most powerful force governing human behavior is social influence. People will do most anything to gain acceptance or avoid rejection. If health care leaders want to not only secure the well-being of patients but also increase employee retention and engagement, the most immediate and effective step they can take is change this culture of silence. Health care leaders who want to engage social influence to eliminate disruptive behavior must break the code of silence in 4 critical conversational areas.