A Road Map for Advancing the Practice of Respect in Health Care: The Results of an Interdisciplinary Modified Delphi Consensus Study

the Practice of Respect Delphi Study Group

Research output: Contribution to journalArticle

Abstract

Background: Most health care organizations’ efforts to reduce harm focus on physical harm, but other forms of harm are both prevalent and important. These “nonphysical” harms can be framed using the concepts of respect and dignity: Disrespect is an affront to dignity and can cause harm. Organizations should strive to eliminate disrespect to patients, to families, and among health care professionals. Methods: A diverse, interdisciplinary panel of experts was convened to discuss strategies to guide health care systems to embrace an expanded definition of patient harm that includes nonphysical harm. Subsequently, using a modified Delphi process, a guide was developed for health care professionals and organizations to improve the practice of respect across the continuum of care. Results: Five rounds of surveys were required to reach predefined metrics of consensus. Delphi participants identified a total of 25 strategies associated with six high-level recommendations: “Leaders must champion a culture of respect and dignity”; with other professionals sharing the responsibility to “Promote accountability”; “Engage and support the health care workforce”; “Partner with patients and families”; “Establish systems to learn about and improve the practice of respect”; and “Expand the research agenda and measurement tools, and disseminate what is learned.” Conclusion: Harm from disrespect is the next frontier in preventable harm. This consensus statement provides a road map for health care organizations and professionals interested in engaging in a reliable practice of respect. Further work is needed to develop the specific tactics that will lead health care organizations to prevent harm from disrespect.

Original languageEnglish (US)
Pages (from-to)463-476
Number of pages14
JournalJoint Commission Journal on Quality and Patient Safety
Volume44
Issue number8
DOIs
StatePublished - Aug 1 2018

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Delphi Technique
Consensus
Delivery of Health Care
Organizations
Patient Harm
Health Manpower
Continuity of Patient Care
Family Health
Social Responsibility
Research

ASJC Scopus subject areas

  • Leadership and Management

Cite this

A Road Map for Advancing the Practice of Respect in Health Care : The Results of an Interdisciplinary Modified Delphi Consensus Study. / the Practice of Respect Delphi Study Group.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 44, No. 8, 01.08.2018, p. 463-476.

Research output: Contribution to journalArticle

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abstract = "Background: Most health care organizations’ efforts to reduce harm focus on physical harm, but other forms of harm are both prevalent and important. These “nonphysical” harms can be framed using the concepts of respect and dignity: Disrespect is an affront to dignity and can cause harm. Organizations should strive to eliminate disrespect to patients, to families, and among health care professionals. Methods: A diverse, interdisciplinary panel of experts was convened to discuss strategies to guide health care systems to embrace an expanded definition of patient harm that includes nonphysical harm. Subsequently, using a modified Delphi process, a guide was developed for health care professionals and organizations to improve the practice of respect across the continuum of care. Results: Five rounds of surveys were required to reach predefined metrics of consensus. Delphi participants identified a total of 25 strategies associated with six high-level recommendations: “Leaders must champion a culture of respect and dignity”; with other professionals sharing the responsibility to “Promote accountability”; “Engage and support the health care workforce”; “Partner with patients and families”; “Establish systems to learn about and improve the practice of respect”; and “Expand the research agenda and measurement tools, and disseminate what is learned.” Conclusion: Harm from disrespect is the next frontier in preventable harm. This consensus statement provides a road map for health care organizations and professionals interested in engaging in a reliable practice of respect. Further work is needed to develop the specific tactics that will lead health care organizations to prevent harm from disrespect.",
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