Financial Risks of Disruptive Behaviors

The potential costs of disruptive behaviors have been calculated in the following ways:

I. Recruitment and retention

    • RN: $60 000 to $100 000/ additional opportunity costs

II. Adverse events (“No pay” for adverse events initiatives)

    • Medication error: $2000 to $5800 per case; additional increased length of stay (LOS) 2.2-4.6 days

    • Hospital-acquired infection: $20 000 to $38 500

    • Deep vein thrombosis: $36 000; additional increased LOS 4.2 days

    • Pressure ulcer: $22 000; additional increased LOS 4.1 days

    • Ventilator-associated pneumonia: $49 000; additional increased LOS 5.3 days

III. Malpractice: $521 560/ additional opportunity costs

IV. Fines: $25 000 to $100 000

V. Patient satisfaction, hospital reputation, market share implications

VI. Compliance issues

    • Impact on documentation and coding

    • Impact on use efficiency (LOS, resource efficiency, discharge planning)

    • Impact on staff responsibilities (medical records completion, on call, meeting attendance)

    • Impact on quality (availability, responsiveness)

VII. Administrative issues

     • Impact on productivity and efficiency (nonproductive activities, waste, delays, absenteeism)

     • Impact on staff morale and satisfaction

( from Rosenstein, A. H. (2011). The quality and economic impact of disruptive behaviors on clinical outcomes of patient care. American journal of medical quality : the official journal of the American College of Medical Quality, 26(5), 372–379. doi:10.1177/1062860611400592)

Dr. Patrick Hudson MD, FACS, BCC is a Fellow of the American College of Surgeons and a Fellow of the National Anger Management Association. He is also a  Board Certified Plastic Surgeon and a Board Certified Coach. In addition to his medical degrees, he has advanced degrees in Mental Health Counseling, Medical Ethics and Liberal Arts. Dr. Hudson is an anger management specialist certified by the NAMA and is available for coaching and education. He specializes in individual anger management and emotional intelligence coaching for physicians and surgeons.

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