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Sentinel Event Alert 40: Behaviors that undermine a culture of safety

Intimidating and disruptive behaviors can foster medical errors, contribute to poor patient satisfaction and to preventable adverse outcomes, increase the cost of care, and cause qualified clinicians, administrators and managers to seek new positions in more professional environments. Safety and quality of patient care is dependent on teamwork, communication, and a collaborative work environment. To assure quality and to promote a culture of safety, health care organizations must address the problem of behaviors that threaten the performance of the health care team.

Update: June 2021

Behaviors that undermine a culture of safety continue to be a problem in health care. While the term “unprofessional behavior” is preferred instead of “disruptive behavior,” the suggested actions in this Alert remain relevant.

Sentinel Event Alert


Patient Safety Systems (PS) chapter of the Comprehensive Accreditation Manual for Hospitals

Institute for Safe Medication Practices (ISMP) articles on its surveys on intimidation and disrespectful behaviors: