Ask the Expert: What does ’zero-tolerance’ policy mean?

Many medical staffs are adopting a zero-tolerance policy with regard to disruptive behavior, but some hospitals are confused about what exactly it entails. This confusion is because this phrase has been defined as strict and less strict.

• The strict definition implies that a single incident will lead to corrective actions and an automatic loss of membership and privileges.
• The less strict definition states that disruptive behavior is never justified. There is never adequate reason to excuse or explain disruptive behavior.

When used in the "less strict" definition zero-tolerance is part of the setting expectations layer of "The Power of the Pyramid," and if a physician violates the policy at this level, the organization's first step is to provide feedback to that physician and remind him or her of expectation set fourth in the behavior policy. Repeated episodes of disruptive behavior would require the organization to progress through the remaining layers of the pyramid.