Interprofessional Conflict and Medical Errors: Results of a National Multi-Specialty Survey of Hospital Residents in the US

Accreditation Council for Graduate Medical Education, Chicago, IL 60610, USA.
Journal of Interprofessional Care (Impact Factor: 1.4). 01/2009; 22(6):573-86. DOI: 10.1080/13561820802364740
Source: PubMed


Clear communication is considered the sine qua non of effective teamwork. Breakdowns in communication resulting from interprofessional conflict are believed to potentiate errors in the care of patients, although there is little supportive empirical evidence. In 1999, we surveyed a national, multi-specialty sample of 6,106 residents (64.2% response rate). Three questions inquired about "serious conflict" with another staff member. Residents were also asked whether they had made a "significant medical error" (SME) during their current year of training, and whether this resulted in an "adverse patient outcome" (APO). Just over 20% (n = 722) reported "serious conflict" with another staff member. Ten percent involved another resident, 8.3% supervisory faculty, and 8.9% nursing staff. Of the 2,813 residents reporting no conflict with other professional colleagues, 669, or 23.8%, recorded having made an SME, with 3.4% APOs. By contrast, the 523 residents who reported conflict with at least one other professional had 36.4% SMEs and 8.3% APOs. For the 187 reporting conflict with two or more other professionals, the SME rate was 51%, with 16% APOs. The empirical association between interprofessional conflict and medical errors is both alarming and intriguing, although the exact nature of this relationship cannot currently be determined from these data. Several theoretical constructs are advanced to assist our thinking about this complex issue.

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    • "This study has demonstrated that the enculturation of students—i .e. the norms, values and practices learned—makes them appreciate different aspects of the environment, which also might have consequences for interprofessional collaboration and communication. Interestingly, residents' perception of involvement in interprofessional conflicts is associated with self-reported medical errors (Baldwin and Daugherty 2008). Higher demands on collaborative and communication skills have stimulated the development of interprofessional education activities, but their effectiveness regarding patient outcomes have been difficult to demonstrate (Reeves et al. 2008). "
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    • "Negative behavior such as use of sarcasm or intimidation occurs among workers in non-healthcare as well as health care industries [11,18,22,39]. Healthcare researchers identified negative behavior at work among medical residents in the United States (US) [5] and the United Kingdom (UK) [27]; nurses in Australia, New "
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    • "Les conflits entre soignants, souvent banalisé s, nuisent a ` la qualité des soins et au maintien d'un bien-e ˆtre durable des e ´ quipes. Les conflits sont source d'erreurs mé dicales [3] [4]. Ils contribuent en grande partie a ` l'e ´ puisement professionnel [5] [6]. "
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