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Identifying high-risk individuals and providing early assistance in the way of coaching or counseling services will increase their satisfaction, productivity and relationships in both the home and work setting. His research began in 1999 while he was the Vice President and Medical Director at VHA West Coast. In his current role as health care consultant and Medical Director of Physician Wellness Services , his primary focus is to continue to investigate the causes and outcomes of disruptive events in an effort to get a better understanding of why these episodes occur and how they can be prevented.
The second component of early intervention is to identify individuals at risk.A  Physicians, nurses and other health care professionals, due to the nature of their positions are working under increasing stress and complexity, which can lead to fatigue, burnout, depression and even suicidal ideation.
I offer the following thoughts for her newsletter series on this topic: There is a difference in the types of disruptive behaviors between physicians and nurses. Alan Rosenstein has spent the last 10 years focusing on the effects of disruptive behaviors on staff relationships, staff retention, communication efficiency, patient safety, and clinical outcomes of care.
Rosenstein enhanced the survey tool to focus on the frequency and impact of physician, nurse, and other staff member disruptive behaviors and their impact on psychological factors known to affect performance (stress, ability to concentrate, communication efficiency, information transfer), and its linkage with negative outcomes of care (errors, adverse events, compromises in patient safety, quality and mortality).


Rosenstein has developed a 10 step model that focuses on the importance of raising levels awareness and accountability, enhancing cultural and leadership commitment, implementing customized education and training programs, developing appropriate policies and reporting procedures, enforcing compliance and intervention processes, and integrating these programs in with the organizationa€™s patient safety, quality, and risk management initiatives.
Recognizing the growing levels of stress, frustration, dissatisfaction, burnout and depression in all health care professions and their impact on attitudes and behaviors, he promotes the advantages of early intervention programs which have the greatest opportunity for success by taking a proactive user friendly approach to raise levels of awareness and accountability, enhance work satisfaction, , improve relationships, and increase productivity and efficiency in health care delivery.
Rosenstein has had more than 40 articles published on this topic and has had extensive experience in providing customized educational programs, workshops and consultative services in this area. Alan Rosenstein has spent the last 10 years focusing on the effects of disruptive behaviors on staff relationships, staff retention, communication efficiency, patient safety,A  and clinical outcomes of care. RecognizingA  the growing levels of stress, frustration, dissatisfaction, burnout and depression in all health care professions and their impact on attitudes and behaviors, he promotes the advantages of early intervention programs which have the greatest opportunity for success by taking a proactive user friendly approach to raise levels of awareness and accountability, enhance work satisfaction, , improve relationships, and increase productivity and efficiency in health care delivery. Rosenstein developed a survey tool to assess the relationship between disruptive physician behaviors, nurse satisfaction, and retention. Surveys were initially distributed to physicians, nurses and administrators at VHA member hospitals.


Results were published in a number of different peer reviewed medical journals including the Joint Commission Journal on Quality and Patient Safety, the Journal of the American College of Surgeons, the Journal of Neurology, the Harvard Policy Review, Nursing Management, and The Physician Executive Journal.
The findings showed a strikingly high incidence of occurrence of physician disruptive behavior with a significant negative impact on nurse satisfaction and retention. The results were published in The American Journal of Nursing and The Physician Executive Journal.



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