Leadership standard clarified to address behaviors that undermine a safety culture.

glossary and in a Leadership standard in the Comprehensive Accreditation Manuals has been revised to behaviors that undermine a culture of safety. This change is applicable to the ambulatory care, behavioral health care, critical access hospital, home care, hospital, laboratory, long term care, and office-based surgery accreditation programs. The Joint Commission introduced revisions in 2009 to the LD chapter, which included the addition of new Standard LD.03.01.01 regarding the culture of safety. Elements of performance (EPs) 4 and 5 of this standard include language about “acceptable, disruptive, and inappropriate behavior” of individuals working in health care organizations. Despite the language of these EPs, the concept is often abbreviated in the field as simply “disruptive behavior.” The Joint Commission decided to use the term disruptive behavior because it was commonly used in the literature and recognized by most individuals in the workplace. However, Joint Commission staff have since learned that the term disruptive behavior is not viewed favorably by some health care practitioners and is even considered ambiguous for some audiences. For example, some physicians have expressed that strong advocacy for improvements in patient care can be characterized as disruptive behavior. Also, the phrase disruptive behavior may be used in the context of a care environment that has become temporarily unsettled by the behavior of a patient, a resident, or an individual served. Using the language behaviors that undermine a culture of safety offers a better way to describe the problem addressed by the standard. This change will appear in the 2012 Update 1 to the Comprehensive Accreditation Manuals and the E-dition, which are scheduled for publication in the spring of 2012. P Leadership Standard Clarified to Address Behaviors That Undermine a Safety Culture