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Peer-to-peer ‘Cup of Coffee’ Chats Stopped Unprofessional Behavior Before It Reached Leadership
Overview
What were we trying to accomplish?
Standardize the way our department manages unprofessional events starting with using a peer-to-peer and stepwise approach rather than an administrative approach.
How will we know that a change is an improvement?
Decrease in professionalism-related events reported through RL reports and HR direct referrals.
Implementation
How long did it take to get up and running?
6 months post CPPA training completion.
How was readiness assessed & required resources identified?
Training & travel expenses for 4 individuals ~ $8500. Seek institutional grant as funding source. Follow-up meeting of attendees (2hours first, 1 hour x 2 additional). Peer training of 2 additional faculty and APPs to reach critical mass of peer messengers.
What were the missteps and lessons learned along the way?
Peer training of additional messengers lost some of the messaging of the original program. Instead of brief “cup of coffee” awareness talks, the talks became discussions with some defensiveness and offered advice rather than letting individuals self-correct their behaviors.
Solution Design
What changes can we make that will result in an improvement?
Train individuals in the Vanderbilt Center for Patient and Professional Advocacy (CPPA) program, which has been implemented in > 200 hospitals and healthcare systems nationwide. Implement the program locally and measure the results. The basis of the program is that the initial approach to a single unprofessional event is a brief (“cup of coffee”) awareness intervention from a peer rather than a member of leadership. Making the individual aware in a non-threatening & non-punitive atmosphere and allowing the individual to reflect on the occurrence and self-correct prevents the majority of repeat behaviors and escalation of unprofessional interactions.
What was your implementation strategy and critical steps?
Send 2 faculty and 2 APPs for CPPA training and used them to train additional team members. Presented material to HR and CMO to obtain buy-in and endorsement.
Adoption & Sustainability
How did you communicate the tactic to those affected by it?
Communicated plan with department with a grand rounds presentation. Posted Vanderbilt professionalism pyramid on department intranet site.
How did you design for sustainability of the change?
Updates at department meetings – brief reminders of program. Feedback from recipients of peer messaging encounters.
Evidence & References
Other References
- Hickson GB, Pichert JW, Webb LE, Gabbe SG. A complementary approach to promoting professionalism: identifying, measuring, and addressing unprofessional behaviors. Acad Med. 2007 Nov;82(11):1040-8. doi: 10.1097/ACM.0b013e31815761ee. PMID: 17971689.
- Baldwin CA, Hanrahan K, Edmonds SW, Krumm AM, Sy A, Jones A, Murphy T, Mitchell S, Davidson HA, Thomas J, Webb L, Doub TW, Cooper WO; CORS Professionalism Collaboratory. Implementation of Peer Messengers to Deliver Feedback: An Observational Study to Promote Professionalism in Nursing. Jt Comm J Qual Patient Saf. 2023 Jan;49(1):14-25. doi: 10.1016/j.jcjq.2022.10.001. Epub 2022 Oct 12. PMID: 36400699.
- civility
- peer support
- professionalism
