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BMJ open quality
Jul 08, 2024;13 (3):

How can interventions more directly address drivers of unprofessional behaviour between healthcare staff?

Justin A Aunger, Ruth Abrams, Russell Mannion, Johanna I Westbrook, Aled Jones, Judy M Wright, Mark Pearson, Jill Maben
Author Information
  1. Justin A Aunger: Midlands Patient Safety Research Collaboration, Institute of Applied Health Research, University of Birmingham, Birmingham, UK j.aunger@bham.ac.uk. ORCID
  2. Ruth Abrams: School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
  3. Russell Mannion: Health Services Management Centre, University of Birmingham, Birmingham, UK.
  4. Johanna I Westbrook: Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia.
  5. Aled Jones: School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK.
  6. Judy M Wright: School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK.
  7. Mark Pearson: Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.
  8. Jill Maben: School of Health Sciences, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK.
PMID: 38977314 DOI: 10.1136/bmjoq-2024-002830

Abstract

Unprofessional behaviours (UBs) between healthcare staff are widespread and have negative impacts on patient safety, staff well-being and organisational efficiency. However, knowledge of how to address UBs is lacking. Our recent realist review analysed 148 sources including 42 reports of interventions drawing on different behaviour change strategies and found that interventions insufficiently explain their rationale for using particular strategies. We also explored the drivers of UBs and how these may interact. In our analysis, we elucidated both common mechanisms underlying both how drivers increase UB and how strategies address UB, enabling the mapping of strategies against drivers they address. For example, social norm-setting strategies work by fostering a more professional social norm, which can help tackle the driver 'reduced social cohesion'. Our novel programme theory, presented here, provides an increased understanding of what strategies might be effective to adddress specific drivers of UB. This can inform logic model design for those seeking to develop interventions addressing UB in healthcare settings.

Keywords

Implementation science Patient safety Professional Role Quality improvement Safety culture

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MeSH Term

Humans
Health Personnel
Professional Misconduct
Patient Safety
Journal Article Review

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