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

Background: Disruptive behaviour amongst healthcare professionals can adversely affect patient care. These behaviours undermine cultures of safety, exposing patients to preventable risk. Existing evidence associates disruptive behaviours with a negative effect at the organisational level and on healthcare professional but the effect on patient care has been less well documented. Objectives: To identify and synthesize the empirical evidence of healthcare professional disruptive behaviours 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 6th and July 23rd 30, 2019, six databases were searched for published empirical studies that examined disruptive behaviours and patient outcomes. Excluded from this pool were studies that did not make associations with patient care. Studies were analysed using thematic analysis. Results: 25 studies met the inclusion/exclusion criteria and were included in the review. The prevalence and type of disruptive behaviour varied but it consistently contributed to a reduction in the quality and safety of patient care. The effect on patient care was manifested through adverse incidents, neglect of care-needs, never events and complaints. Disruptive behaviours significantly impaired the safety culture leading to reduced patient safety, evidenced by worse clinical outcomes. Conclusions: Disruptive behaviours amongst healthcare professionals are a significant threat to patient safety and quality of care. Organisations must harness the benefits of awareness programmes, policy and interventions to generate a culture change where these behaviours are not accepted, thereby protecting patients from preventable harm.