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crucial conversations, disruptive behavior, social influence, sanctions, verbal abuse



  1. Grenny, Joseph BS


The Joint Commission announced this year that rude language and hostile behavior pose serious threats to patient safety and quality of care. And, for good reason. 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.


But while these disruptive and disrespectful behaviors can be hurtful, what prompted The Joint Commission to address them as a condition of accreditation is the mounting evidence that these behaviors are also harmful. The Silence Kills study found that more than 20% of healthcare professionals have seen actual harm come to patients as a result of such behavior.


The most powerful force over human behavior is social influence. People will do almost anything to gain acceptance or avoid rejection. If healthcare leaders want to not only secure the well-being of patients but also increase employee retention and engagement, the most immediate and effective thing they can do is to change this culture of silence.


Healthcare leaders who want to engage social influence to eliminate disruptive behavior will have to break the code of silence in 4 crucial conversations.