A tool that uses peer messaging to address disrespectful behavior in the workplace can be successfully applied in the nursing workforce, a new study has found.
The tool, called the Co-Worker Observation System (CORS), allows behavior to be anonymously reported and addressed by a trained peer, without involving nursing leadership or human resources unless necessary. CORS data collected over 10 years shows that most people listen to peer criticism and self-correct, said the developers, from Vanderbilt University Medical Center in Nashville, TN.
The current study examined the feasibility of implementing CORS for staff nurses at VUMC and two other academic medical centers. CORS has previously been implemented for doctors and advanced practice providers.
Documenting behaviors
CORS encourages healthcare workers to address professional behavior in the moment. When that doesn’t happen, co-workers can document their observations electronically. These reports are screened using natural language processing software and coded by trained CORS coders. A trained nurse messenger, selected as a peer based on role and tenure, shares the observation with the nurse who offended the reporting co-worker. The reporter’s name is not divulged.
Investigators examined 590 reports from September 2019 to August 2021. Most reports included more than one unprofessional behavior for a total of 1,367 recorded. Investigators found that:
- 49% of behaviors were related to issues of unclear or disrespectful communication;
- 33% were related to performing duties and tasks that are part of a role;
- 7% were related to appropriate medical care;
- 6% to were related to professional integrity; and
- 5.2% were “a report of concern” or possibly egregious, the researchers reported.
With the correct training, nurses delivered CORS messages to their peers, the study found. Most (92%) of nurses in the study never received a CORS behavior report.
Two sides to each story
Much unprofessional behavior does not arise from workplace issues, but rather outside life stressors, said senior investigator Cindy Baldwin, MS, RN.
“We want to make sure that people hear or understand how they’re being perceived, whether it’s a one-time thing or it’s a pattern, without immediately going to progressive discipline,” she said.
The peer-reporting system allows a trained peer messenger to resolve the issue without reporting it to nursing leadership or human resources unless required by policy or law. The understanding is that that there are two sides to each story, the researchers said.
Full findings were published in the The Joint Commission Journal on Quality and Patient Safety.
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