How a Culture of Professionalism Affects Patient Care
With Medicare placing a higher level of importance on quality of care when it comes to reimbursement payments, improving patient care has never been more critical for healthcare organizations. Despite these changes, it seems that patient care hasn’t improved significantly over the last years according to research. In an editorial article published in 2013 in the BMJ Quality & Safety journal, researchers Kaveh Shojania and Eric Thomas explain how progress seems ‘sorely lacking’ for patient safety: “sustained attention to patient safety has failed to produce widespread reductions in rates of harm medical care.”
Given these disappointing findings, a recent article published in the April 2014 edition of The Joint Commission Journal on Quality and Patient Safety discusses that a culture of professionalism can reduce medical errors, adverse events, and unsafe work conditions. Specifically, researchers Shapiro et al. described the development of the Center for Professionalism and Peer Support (CPPS) at a Boston hospital and its results on the professional behavior of physicians. Their findings indicate that mandatory education sessions on professional development are successful in engaging physicians in discussing and participating in an enhanced professionalism culture. In addition, the study found incidents of increasingly less severe unprofessional behavior among their team members.
Based on the findings by Shapiro et al., how can your healthcare organization adopt a culture of professionalism? Here are a few items to consider from this study’s takeaways.
Culture ‘Learning’ Starts at Orientation
In the study, the Boston-based hospital began introducing its professionalism initiative during the orientation seminar for all new interns, residents, fellows, staff physicians, and scientists. It’s important to include culture learning at the time of orientation because it establishes expectations and boundaries for acceptable behavior. In an article for Great Place to Work, Lisa Zatulovsky suggests orientation is an ideal time for immersing new staff members in the company’s culture. “Making new hires accountable for noticing how their colleagues and managers live those values every day brings those behaviors to life,” Lisa states.
Establish a Code of Conduct
In order to enforce a culture of professionalism, it’s important to have a documented code of conduct. By providing your staff members with clear expectations of what type of behavior is acceptable at your organization, you can help set your professionalism initiatives for success. A code of conduct was part of the methodology in the Shapiro et al. study. Not only does a code of conduct help communicate your expectations to staff members, but it will also help you enforce your professionalism culture once incidents are reported.
Conduct Mandatory Educational Programs
While it’s important to cover culture during orientation, it’s also critical to train your current staff members on your professionalism initiatives. In order for your program to be successful, you need to involve all of your organization to ensure widespread adoption and adherence to expectations. UC Davis Health System, for example, offers a Mandatory Annual Training (MAT) course that covers topics which can significantly impact personal, patient, and environmental safety based on the Joint Commission, the State of California, the Department of Public Health, and the health system itself. The course also covers the code of conduct and its content is updated annually to incorporate the annual patient safety goals specified by the Joint Commission. UC Davis Health System also offers a separate Ethical Values and Conduct Training course that covers how to report the potential instances of non-compliance and fraud, which brings us to the next point.
Have a Process for Reporting, Assessing, and Managing Concerns
You’ve written a thorough code of conduct and trained all of your staff, but it’s also necessary to have an effective process in place for reporting, assessing, and addressing concerns that are reported by team members. Make sure you establish your process for handling reports so that you are ready once your professionalism culture has taken off. If you are unsure where to start, take a look at Johns Hopkins School of Medicine’s procedures for dealing with issues of professional misconduct. In their process, for example, the initial responsibility to attempt to resolve matters rests with the relevant department director. Make sure that you tailor your process to fit your organization. While it may work for Johns Hopkins, every organization is unique.
These are just a few points to think about when establishing a culture of professionalism at your organization. With research indicating that an environment that embraces professionalism can improve patient care, making it part of your organization’s culture seems like a worthwhile initiative.
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Shapiro, J., Whittemore, A., & Tsen, L. (2014). Instituting a culture of professionalism: The establishment of a Center for Professionalism and Peer Support. The Joint Commission Journal on Quality and Patient Safety, (40)4, 33-42.
Shojania, K., & Thomas, E. (2013). Trends in adverse events over time: Why are we not improving? BMJ Quality & Safety, (22)4, 273-277. Accessed June 2014.