A LOOK AT THE JOINT COMMISSION
•Poor management skills
•Role conflict or ambiguity
•Lack of autonomy
Gerry Hickson, MD, and
colleagues at Vanderbilt
University Medical Center,
Nashville, TN, determined
that a common barrier in the
fight against bullying was
underreporting of the issue.
In response, they created
a Co-Worker Observation
Reporting System to encourage
accountability and respect among
coworkers. 5 This reporting system
allows coworkers to document
observed acts of bullying, which
provides an inventory of such
events and an opportunity for
administrators to address these
issues through education and
Health care organization
leaders also can play a role in
battling bullying by creating
a safety culture that doesn’t
tolerate bullying behaviors,
confronts bullies, and
supports their victims.
The Joint Commission
also highlighted some safety
actions to consider in Sentinel
Event Alert, Issue 40, which
include the following: 6
•Educating team members on
•Holding team members
•Developing anti-bullying policies
Surgeons must lead
I believe that surgeons can
play a substantial role in the
fight against bullying in the
health care field. Not only do I
believe that we should always
self-monitor to ensure that our
statements, our actions, and our
attitudes are not interpreted as
bullying, but that we also have
an obligation to observe and
counsel our colleagues who
may exhibit those behaviors.
Surgeons should leverage
their visibility, their position in
the hierarchy of an organization,
the way that other health care
providers perceive the role of
surgeons, and their capacity to
influence institutional policies
and procedures to create and
maintain an environment that
is positive—for the health care
workers, the surgeons and, most
importantly, the patients.
For more, read a Quick
Safety report on workplace
bullying at bit.ly/28KusuG. ♦
The thoughts and opinions
expressed in this column are
solely those of Dr. Pellegrini and
do not necessarily represent those
of The Joint Commission or the
American College of Surgeons.
1. Ariza-Montes A, Muniz NM,
Montero-Simo MJ, Araque-Padilla
RA. Workplace bullying among
healthcare workers. Int J Environ Res
Public Health. 2013; 10( 8):3121-3139.
2. Occupational Safety and Health
Administration. Workplace violence
in health care: Understanding the
challenge. OSHA 3826, 12/2105.
Available at: www.osha.gov/
Accessed May 18, 2016.
3. Workplace Bullying Institute. The
Healthy Workplace Campaign.
Healthy Workplace Bill website.
Available at: healthyworkplacebill.
org/problem/. Accessed May 14, 2016.
4. Rayner C, Hoel H. A summary
review of literature relating to
workplace bullying. J Comm Applied
Social Psych. 1997;7:181-191.
5. Webb LE, Dmochowski RR,
Moore IN, et al. Using coworker
observations to promote
accountability for disrespectful and
unsafe behaviors by physicians and
advanced practice professionals.
Jt Comm J Qual Patient Saf.
2016; 42( 4):149-161.
6. The Joint Commission. Issue 40:
Behaviors that undermine a culture of
safety. Sentinel Event Alert. July 9, 2008.
Available at: www.jointcommission.
culture_of_safety/. Accessed August
Health care organization leaders also can play a role in battling
bullying by creating a safety culture that doesn’t tolerate bullying
behaviors, confronts bullies, and supports their victims.