This observational study looked at whether patients whose surgeons were more often reported by coworkers for unprofessional behavior were at greater risk of postoperative complications. The analysis included data from reports of unprofessional behaviors by coworkers for 202 surgeons from two academic medical centers, as well as data on surgical and medical complications within 30 days of operation for 13,653 patients. Reported unprofessional behaviors included concerns about poor or unsafe care, clear and respectful communication, and integrity. Among patients, 1,583 (11.6%) experienced a complication. Study authors report patients whose surgeons had more reports by coworkers of unprofessional behavior were more likely to experience a complication. Read the full study.
In this retrospective study reviewed unsolicited patient complaints (UPCs) associated with US otolaryngologists from 140 medical practices from 2014 to 2017. Five percent of otolaryngologists were associated with 23% of all UPCs. Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention (P= .049). Twenty otolaryngologists (69%) categorized as "responders" reduced the number of complaints an everage of 45% in the first 2 years following intervention. Read the full study or listen to the podcast.
In this video, William O. Cooper, M.D., M.P.H. explains how patients whose surgeons had a history of higher numbers of patient complaints had an increased risk of surgical and medical complications, according to a study published by JAMA Surgery.
In collaborations with 144 U.S. hospitals, healthcare systems and medical groups, we performed a nested case-control study using PARS data of 33,814 physicians. This study, published in The American Journal of Geriatric Psychiatry, examined words contained in unsolicited patient complaints and their alignment with physicians who may have cognitive impairment disorders. The findings in Unsolicited Patient Complaints Identify Physicians with Evidence of Neurocognitive Disorders suggest a methodology for determining which physicians might warrant additional assessments without imposing testing burdens on all older physicians.
In this editorial, Every patient should be enabled to stop the line, Drs. Sigall Bell and William Martinez (VUMC) explore how changing the way we think about and learn from patient concerns may lead to increased patient safety and respect, emotional harm prevention, improved patient experience, and enhanced organization learning. True patient engagement requires fully making room for patients at the table; it means changing the speaking up research to focus on patient-centered outcomes, better learning from existing patient feedback, and creating the conditions in which patients feel comfortable bringing their voices into our healthcare system. Creating environments in which patients and families can speak up makes more sense now than ever before, because the underlying principles resonate with other existing broad cultural shifts in medicine, such as transparency, patient engagement, shared decision making, inclusivity and respect.
Representing a collaboration between Vanderbilt’s CPPA, Ophthalmology and Biostatistics departments, and MPH program, the study found that older ophthalmologists were less likely than younger colleagues to be associated with patient complaints. Our findings reinforce the importance of patients’ observations, which can provide actionable information for individual physicians and leaders committed to providing high quality care. Furthermore, complaints may signal a need for physical, mental and/or skills assessments, especially for older physicians who previously had few or no complaints, but then manifest rapid increases.
"When Surgeons Are Abrasive To Coworkers, Patients' Health May Suffer". Susie Neilson reported a story for NPR News featuring the JAMA Surgery study on Co-Worker Concerns that Dr. William Cooper published along with CPPA faculty and collaborators from Stanford and Penn Medicine. Susie spoke with Dr. Cooper who pointed out "The vast majority [of surgeons] take care of their patients, are respectful to their coworkers," he says. "A very small proportion account for a disproportionate share of adverse outcomes…Awareness can often improve surgeons' behavior."
Dr. William Cooper's study on Co-Worker Concerns published in JAMA Surgery was picked up by Michael Nedelman at CNN Health News. His article, "After surgery, how patients fare may depend on how their doctor behaves, study says" highlights the research of Dr. Cooper with CPPA faculty along with collaborators from Stanford and Penn Medicine and points out the importance of reporting disrespectful behaviors. He spoke with Dr. Cooper who stated, "We really think about these reports as being a tip of the iceberg of these behaviors but an important measure that we can then connect to patient outcomes."
Dr. Lynn Webb will represent the Vanderbilt Center for Patient and Professional Advocacy at the Austalian and New Zealand Prevocational Medical Education Forum in Melbourne in November 2018. As Assistant Dean for Faculty Development and Assistant Professor of Medical Education and Administration at Vanderbilt University Medical Center, he will share CPPA's years of research on Promoting Professionalism and a Culture of Safety and Respect. The sessions will include having a "Cup of Coffee Conversation" which promotes a culture of speaking up when concerns arise. This will give participants the tools necessary to address those concerns in a professional manner and techniques to build that into the culture of an organization.
Dr. William Cooper represented CPPA at the "What Patients Say" National Conference on October 11 and 12, 2018 in Chicago. What patients say in their own words is increasingly being used for many purposes for getting results above and beyond simple patient survey ratings. This conference featured research and national best practices about the wide variety of ways that the patients' concerns are being collected and used and how these efforts can be linked in powerful ways. Read more about this conference championed by Rush University Medical Center.
Dr. Gerald Hickson was honored to speak at Geisinger Health System as part of their Rock Star Speaker Series in March 2018. The Geisinger Rock Star Speaker Series seeks to bring people of influence across all industries to speak to Geisinger leadership; hearing from national thought leaders, government leaders, health care leaders, and scientific leaders to discuss topical health care issues and health policy. Other notable speakers include: Mark Miller, PhD, Marilyn Tavenner, Mandy Cohen, MD, Joe Selby, MD, Peter Orszag, PhD, Karen DeSalvo, MD, Rick Pollack and Tom Nickels, Shantanu Agrawal, MD.
In May 2018, Dr. Tom Catron and Dr. April Kapu presented Workforce Safety: A Prerequisite for Joy in Work at the Institute for Healthcare Improvement Conference in Boston. They focused on promoting advanced practice professionals' accountability for safe, kind, reliable care. Recognizing the impact unprofessional behavior has on patient safety, clinical outcomes, and teamwork, means health care leaders require tools and reliable processes for identifying and addressing providers who undermine a safety culture. Using case-based, interactive teaching methods, group discussion, and practice exercises, participants learned proven tools and techniques for having "awareness" conversations to help advanced practice nurses and other medical professionals recognize an actionable pattern of slips and lapses in professional behavior so they have an opportunity to self-correct.
The international journal, HealthManagement, featured Dr. Cooper's Pursuing a Culture of Safety in their August issue. The journal has a distribution to 87 countries world-wide.
Dr. Cooper points out, "Whereas much is written about professionalism and its noble tenets, far too little attention has been focused on understanding a critical component of professionalism—the commitment to group and self-regulation".
Dr. William Cooper, Director of Vanderbilt's Center for Patient and Professional Advocacy was recently interviewed by HealthLeaders Media concerning our center's work in promoting professionalism in healthcare., More specifically, Dr. Cooper discusses our recently published work on how co-worker observations can promote greater professional accountability in healthcare organizations
The Journal of the American Society of Anesthesiologists, Inc. featured CPPA in their Science, Medicine, and the Anesthesiologist publication in October, 2017: "Use of unsolicited patient observations to identify surgeons with increased risk for postoperative complications."
Using Coworker Observations to Promote Accountability for Disrespectful and Unsafe Behaviors by Physicians and Advanced Practice Professionals is the cover story of the April 2016 issue of The Joint Commission Journal of Quality & Patient Safety. Our latest publication gives readers a practical roadmap for implementing a program for soliciting co-worker observations and an infrastructure for dealing with identified issues. We have also been honored by an accompanying editorial by Richard C. Boothman, JD. In addition, Becker's Hospital Review provides a summary of the work as well as links to The Joint Commission Journal article HERE
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