Creating a culture of safety and respect: a controlled, mixed-methods study of the effectiveness of a behavioural accountability intervention to reduce unprofessional behaviours

Unprofessional behaviour in healthcare is widespread, and significantly undermines the effective functioning of teams, staff wellbeing, patient experience and safety, and organisational productivity. Unprofessional behaviours are associated with higher staff turnover, incidence of patient dissatisfaction, medicolegal risk and significant financial costs. There is a pressing need for evidence-based interventions to reduce the prevalence of negative behaviour, minimise its impact on staff and patients, and normalise a culture of safety and respect.

This project will assess the effectiveness of an innovative structured staff behaviour and escalating accountability intervention, the Ethos program, to be rolled out across St Vincent’s Health Australia hospitals. The study will assess the ability of the Ethos program to reduce unprofessional behaviours, improve the experience of staff, and improve the safety, experience and outcomes of patients. It will also identify enablers and barriers to Ethos program effectiveness and enhance spread and sustainability. The project is a controlled, before and after study using qualitative and quantitative methods – including surveys, interviews, direct observation, HR and patient outcome data linkage.