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Toxic Behaviors in the Medical Practice: Zero Tolerance,
What to do About it

Toxic Behaviors in the Medical Practice: Zero Tolerance, What to do About it


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by Mitchell Kusy and Elizabeth Holloway

How pervasive is work incivility?

  • 94% of leaders work with toxic, uncivil people
  • 92% rated their behaviorÃ…fs severity from 7 to 10 on a 10-point scale; 42.5% at 9 to 10
  • Are you throwing away money at a problem with the wrong fixes? Consider:

  • 50% of staff say they cannot respond to verbal abuse
  • 68% declined in performance
  • 78% had less commitment to the organization
  • 12% of victims quit
  • Fully loaded costs of subsequent turnover are 1.5 to 2.5 times the personÃ…fs salary
  • Other studies: 49% connected intimidation with medication errors, 20% patient harm, and 25% with patient mortality!
  • Respectful engagement is about real behaviors that make a difference in what we refer to as the triple bottom-line: patient safety, productivity, and financial performance. We present a systems approach, based on our national study, addressing the countervailing forces reducing respect and the proactive measures to achieve human and financial strength. This corroborates the 2009 Joint Commission Accreditation Standards for Hospitals, in which hospitals must develop a code of conduct defining acceptable and disruptive behaviors, along with a process for managing uncivil, inappropriate ones. The audio conference will focus on the strategies of the Toxic Organization Change System (TOCS) and building communities of respectful engagement. Learning objectives include:

    1. Organizational strategies:
  • A performance management system that identifies respect in your appraisal process, 360 feedback, recruiting, and leadership development
  • A 60-40 (task-values) split for best performance
  • Skip-level review to deter Ã…gkiss up / kick downÃ…h folks
  • 2. Team strategies:
  • Translation of organizationÃ…fs values into team norms
  • Systemic feedback to toxic protectors and toxic buffers
  • Using and teaching the 4-step apology
  • 3. Individual strategies:
  • T.O.T.A.L. model for giving feedback
  • 4-step model from feedback to suspension
  • Meet Our Expert Speakers:

    Mitchell Kusy, Ph.D. a Fulbright Scholar in International Organization Development and
    Professor at Antioch UniversityÃ…fs Ph.D. Program in Leadership & Change, was head of leadership development for American Express and director of organization development at HealthPartners. Author of several business books, he consults in strategic planning, organization development, and the design of organizations of respectful engagement. He received the 1998 Minnesota Organization Development Practitioner of the Year Award. Dr. Kusy is a principal in Real Organization Impact, International (ROI).

    Elizabeth Holloway, Ph.D. a Fellow of the American Psychological Association and Diplomat in
    Professional Psychology is a professor at Antioch UniversityÃ…fs Ph.D. Program in Leadership & Change. She was a Leadership Fellow at the University of WisconsinÃ…]Madison and consults with leaders worldwide on systems approaches to supervision, mentoring, coaching, toxicity, and building communities of respectful engagement. She has published extensively in research and training of supervision in professional practice.

    Moderator: Nancy Collins, Publisher of The Journal of Medical Practice Management®