title: Highly reliable behaviors.
abstract: A lack of respect between nursing and medical disciplines can lead to a lack of trust and disruptive behaviors that are a significant part of the culture of health care today. In order to ensure the best care for all patients, a systematic approach to defining desired and undesired behaviors is a place to begin. A systems view requires an appreciation of local culture and operations. Understanding the underlying root causes in different departments and specialties allows for the development and implementation of sustainable solutions which will ultimately change and transform an organization. Leadership action and commitment at the highest strategic level is essential for this to occur.
authors.affiliation: Joint Commission Center for Transforming Healthcare, 1 Renaissance Blvd, Oakbrook Terrace, IL 60181 USA.
authors.forename: Erin S
authors.initials: ES
authors.lastname: DuPree
keywords: Disruptive behavior; High reliability; Nurse-physician conflicts; Safety culture