Perception of intimidation in a perioperative setting.

Intimidation in health care settings can negatively affect patient safety. Following an adverse event in 2006 at Spectrum Health, a 7-hospital health care system in Grand Rapids, Michigan, leadership of the Grand Rapids perioperative services department led an initiative to evaluate and reduce the incidence of intimidation in the department. Physicians were surveyed to ascertain their beliefs about behaviors that constitute intimidation and to correlate those findings with definitions of intimidation identified by several national professional organizations. Our findings suggest that a majority of physicians in perioperative services agree that behaviors identified as intimidating by national organizations actually constitute intimidation in only 4 of 9 instances and that, for even the most egregious behaviors, there is lack of complete agreement that the behavior constitutes intimidation.These findings suggest reasons why traditional means of addressing intimidating behavior may not be effective and also suggest alternative means of handling behaviors that disrupt the care environment.