Course overview

An evidence-based programme proven to address unprofessional behaviour and improve safety culture

The Promoting Professional Accountability (PPA) programme provides healthcare organisations with a sustainable, organisation-wide framework to achieve the highest levels of safety and reliability. It helps to identify, engage with and hold accountable staff who demonstrate repeated unprofessional behaviour.

This evidence-based programme provides a framework for defining critical safety and professionalism standards, and identifying, measuring and addressing behaviours that undermine them.

Read about Ramsay Health Care’s implementation of the Promoting Professional Accountability programme.

Speaking Up

Cognitive Institute promotes and supports development of an organisational culture where all staff feel safe to speak up about any safety issue and the receiver welcomes it.

However if speaking up face to face is not possible, safe or effective and not related to imminent patient harm, there is an important role for the organisation to represent a staff member and share the message on their behalf.

The PPA programme ideally works alongside the Speaking Up for Safety™ programme to embed an organisation-wide speaking up culture.

Addressing unprofessional behaviour

Research and experience has identified that unprofessional behaviour regularly goes unaddressed by colleagues and leaders as it can be difficult to define. It is often open to interpretation and frequently challenged.

The Promoting Professional Accountability programme helps organisations quantify unprofessional behaviour and contextualise it in terms of ‘unsafe care’, providing leaders and organisations with the confidence and mechanisms to address it.

The programme builds on the professionalism and commitment of the majority of staff, while ensuring the actions of no one individual can undermine a culture of safety and reliability.

Delivered in partnership with Vanderbilt University

The Promoting Professional Accountability programme is based on the work of the Vanderbilt Center for Patient and Professional Advocacy in the United States. Extensively researched and published research discusses the effectiveness of the programme, or its components, in areas relating to hand hygiene, self-regulation and reduced complaint risk.

Cognitive Institute has the exclusive licence to deliver the Promoting Professional Accountability programme for Australia and South East Asia. Our faculty have undertaken intensive training and accreditation from Vanderbilt Centre for Patient and Professional Advocacy (CPPA) to be able to deliver the PPA programme in this region. Cognitive Institute delivers this programme under strict licence terms and conditions.

In partnership with Vanderbilt University

Programme Implementation

The success of the Promoting Professional Accountability programme is maximised by an organisation-wide, three-stage approach: commitment, readiness and implementation. Your investment covers all aspects of these three stages including considerable senior leader training and facilitation, peer-messenger and all-staff workshops. This model ensures commitment to a ‘no blink’ approach by board and executive leaders.

Three stages

Commitment
The Commitment stage is aimed at informing the board, executive and senior medical clinicians about the PPA programme, their role in its implementation and the level of commitment required for its success.

Readiness
This stage assesses the organisation’s readiness and prepares the organisation to implement the PPA programme.

Implementation
The final Implementation stage provides the necessary training required to implement the PPA programme. It includes all-staff seminars, peer messenger training, leadership training and coaching and feedback support for leaders and peer messengers to support their ongoing effective implementation and ensure a sustainable programme.

Peer Messengers
Critical to the success of the PPA programme is its innovative approach of delivering informal conversations about single reported incidents, utilising carefully selected, expert trained peer messengers.

In addition to selecting and training peer messengers, the PPA programme delivers training to leaders throughout the organisation to provide them with the skills required to support the programme.

Understanding common excuses, rationalisations, denials, and barriers to change prepares leaders to appropriately, consistently and professionally address the real issues related to addressing unprofessional behaviours.

Outcomes

The Promoting Professional Accountability programme is a powerful intervention that can transform your healthcare organisation’s culture. However, poorly implemented it can jeopardise expected gains and may even worsen an organisation’s culture of professionalism and accountability.

Addressing unprofessional behaviour has significant benefits for your organisation including:

improved patient safety attributable to greater staff willingness to speak up; first to colleagues and, when necessary, reporting incidents
improved staff satisfaction and retention
enhanced reputation for the organisation, board and executive
reduced costs through greater reliability and reduction of unwanted variability
creation of a culture of professionals who are important role models for students, residents, staff, and each another
reduced liability exposure and risk management activity
overall more productive, civil, and desirable work environments
engagement of clinicians at all levels.

Programme results

Published research has discussed the effectiveness of the Promoting Professional Accountability programme, or its components, in areas relating to hand hygiene, self-regulation and reduced complaint risk.

Implementing the Promoting Professional Accountability programme was found to encourage self-regulation¹ and many of the principles that underpin the Promoting Professional Accountability programme were used by Vanderbilt University Medical Centre to consistently improve hand hygiene compliance beyond 85%²
Vanderbilt University School of Medicine found approximately 60% of physicians’ complaint scores improved after a level-one awareness intervention³
Another study has shown that most physicians who receive interventions respond with an 80% reduction in their complaint risk score⁴.

^{1 Webb LE, Dmochowski RR, Moore IN, Pichert JW, Catron TF, Troyer M, Martinez W, Cooper WO, Hickson GB. Using coworker observations to promote accountability for disrespectful and}
^{unsafe behaviors by physicians and advanced practice professionals. Jt Comm J Qual Patient Saf 2016; 42(4):149-64}
^{2 Talbot TR, Johnson JG, Fergus C, Domenico JH, Schaffner W, Daniels TL, Wilson G, Slayton J, Feistritzer N, Hickson GB. Sustained improvement in hand hygiene adherence: utilizing shared}
^{accountability and financial incentives. Infect Control Hosp Epidemiol 2013; 34(11):1129-36.}
^{3 Hickson GB, Pichert JW, Webb LE, Gabbe SG. A complementary approach to promoting professionalism: identifying, measuring, and addressing unprofessional behaviors. Acad Med}
^{2007; 82(11):1040-8}
^{4 Hickson GB, Cooper WA. Pursuing Professionalism (But not without an infrastructure). In: Byyny RL, Papadakis MA, Paauw DS, editors. Medical professionalism: best practices. Melo Park,}
^{California: Alpha Omega Alpha Honor Medical Society 2015:81-98.}

Costs

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An evidence-based programme proven to address unprofessional behaviour and improve safety culture.

The Promoting Professional Accountability (PPA) programme provides healthcare organisations with a sustainable, organisation-wide framework and training to achieve the highest levels of safety and reliability.

Download course brochure

Type	For organisations
Duration	Multi-day
Delivery Mode	In-house at your organisation
Participants	Varied
Delivered By	Experienced Cognitive Institute medical faculty

Promoting Professional Accountability programme