7 Lessons from AHA's Leadership Summit

2. Insidious intimidation is a problem

Theresa Zimmerman, past president of the American Society for Healthcare Risk Management, described the emerging recognition of insidious intimidation, a type of intimidation much more subtle, and well, insidious, than the yelling and screaming or overtly threatening kind. 

This is when co-workers show "reluctance or refusal to answer questions, return phone calls, or answer pages, [use] condescending language or voice intonation, are impatient with questions and manifest other behaviors that are damaging to team effectiveness and compromise patient safety," she said.

"It's the person who doesn't answer the call light; who disappears when they know a new admission comes into the unit, and doesn't jump in as a team approach, or when they see something is not going a well as possible, [that they] conveniently take their breaks," Zimmerman added.

She went on to explain that this divisive behavior is "eating away at the morale of our teams...and is starting to threaten the actual legitimacy of our quality indicators." Now quality is being linked to payment, she emphasized, and the audience seemed to get her point on how this behavior could impact their quality scores. 

3. Surgical standardization is getting serious

Guido Bergomi, director of Project Management of the Quality and Patient Safety Institute of the Cleveland Clinic, had a story he told those gathered at a forum on surgical site infections:

"It used to be surgeons did their own skin prep of patients, and as much as surgeons standardized, they were standardized. But when we looked we found they were really doing different things in very different ways.