Session: Financial implications of unprofessional behavior in the OR

Editor's Note

In this presentation, Lynn Webb, PhD, assistant dean for faculty development and assistant professor of Medical Education and Administration at Vanderbilt University Medical Center, made a compelling argument for how unprofessional behavior on the part of clinical staff—including OR personnel—has a direct impact on the financial performance of the organization.

“If there’s anything I learned at this conference, it’s that you business leaders love data,” Webb quipped before he proceeded to gather some data of his own. Through a real-time, interactive platform, he presented one scenario of unprofessional behavior in the clinical setting and polled the audience with the following questions:

• Was the scenario a threat to patient safety?
• What percent of the time would someone speak up or report the event?
• Why might someone be reluctant to speak up or report?
• Why should someone report?

The room mostly agreed on the responses, which enforced Webb’s pre-compiled data. (The results of the live poll will be discussed in more detail in a future OR Manager article.) The following are some of the figures he shared:

• 35%–50% of physicians are not associated with unsolicited complaints; that translates to about 4% of “claims dollars”
• just 5% of physicians are associated with 35% of unsolicited complaints and 50% of claims dollars
• those 5% of physicians are more likely to have poor surgical outcomes.

Other studies were cited to show a clear correlation between unprofessional behavior that led to patient/staff complaints and higher costs / poor outcomes. Attendees also were introduced to PARS (patient advocacy reporting system) and CORS (co-worker observation reporting system) as effective monitoring systems; the concept of Credo; as well as to a human resources process to promote professional accountability and address observations of unprofessional behavior in the OR.

The data highlighting the potential costs savings associated with course-correcting unprofessional behavior—course-correction that often did not require much intervention from senior leadership beyond organizing peer-led coffee sessions, as shown by Webb—were staggering.