Qualitative Content Analysis of Coworkers' Safety Reports of Unprofessional Behavior by Physicians and Advanced Practice Professionals.

Autor:	Martinez W; From the Division of General Internal Medicine and Public Health., Pichert JW; Center for Patient and Professional Advocacy., Hickson GB; Quality, Safety, and Risk Prevention., Braddy CH; Vanderbilt Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Brown AJ; Center for Patient and Professional Advocacy., Catron TF; Center for Patient and Professional Advocacy., Moore IN; Center for Patient and Professional Advocacy., Stampfle MR; Center for Patient and Professional Advocacy., Webb LE; Center for Patient and Professional Advocacy., Cooper WO; Center for Patient and Professional Advocacy.
Jazyk:	angličtina
Zdroj:	Journal of patient safety [J Patient Saf] 2021 Dec 01; Vol. 17 (8), pp. e883-e889.
DOI:	10.1097/PTS.0000000000000481
Abstrakt:	Objectives: The aims of the study were to develop a valid and reliable taxonomy of coworker reports of alleged unprofessional behavior by physicians and advanced practice professionals and determine the prevalence of reports describing particular types of unprofessional conduct. Methods: We conducted qualitative content analysis of coworker reports of alleged unprofessional behavior by physicians and advanced practice professionals to create a standardized taxonomy. We conducted a focus group of experts in medical professionalism to assess the taxonomy's face validity. We randomly selected 120 reports (20%) of the 590 total reports submitted through the medical center's safety event reporting system between June 2015 and September 2016 to measure interrater reliability of taxonomy codes and estimate the prevalence of reports describing particular types of conduct. Results: The initial taxonomy contained 22 codes organized into the following four domains: competent medical care, clear and respectful communication, integrity, and responsibility. All 10 experts agreed that the four domains reflected essential elements of medical professionalism. Interrater reliabilities for all codes and domains had a κ value greater than the 0.60 threshold for good reliability. Most reports (60%, 95% confidence interval = 51%-69%) described disrespectful or offensive communication. Nine codes had a prevalence of less than 1% and were folded into their respective domains resulting in a final taxonomy composed of 13 codes. Conclusions: The final taxonomy represents a useful tool with demonstrated validity and reliability, opening the door for reliable analysis and systems to promote accountability and behavior change. Given the safety implications of unprofessional behavior, understanding the typology of coworker observations of unprofessional behavior may inform organization strategies to address this threat to patient safety. Competing Interests: The authors disclose no conflict of interest. (Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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