The Effect of Health Care Professional Disruptive Behavior on Patient Care: A Systematic Review

Abstract

Background: Disruptive behavior among health care professionals can adversely affect patient care. These behaviors undermine cultures of safety, exposing patients to preventable risk. Existing evidence associates disruptive behaviors with a negative effect at the organizational level and on the health care professional, but the effect on patient care has been less well documented.

Objectives: This study aimed to identify and synthesize the empirical evidence of health care professional disruptive behaviors on the following outcome measures of patient care: clinical outcomes, patient safety, patient satisfaction, or quality of care.

Methods: A systematic literature review was conducted. Between June 6 and July 23, 2019, 6 databases were searched for published empirical studies that examined disruptive behaviors and patient outcomes. Excluded from this pool were studies that did not make associations with patient care. Studies were analyzed using thematic analysis.

Results: Twenty-five studies met the inclusion criteria and were included in the review. The prevalence and type of disruptive behavior varied, but it consistently contributed to a reduction in the quality and safety of patient care. The effects on patient care was manifested through adverse incidents, neglect of care needs, never events, and complaints. Disruptive behaviors significantly impaired the safety culture leading to reduced patient safety, evidenced by worse clinical outcomes.

Conclusions: Disruptive behaviors among health care professionals are a significant threat to patient safety and quality of care. Organizations must harness the benefits of awareness programs, policy, and interventions to generate a culture change where these behaviors are not accepted, thereby protecting patients from preventable harm.