Date of Award


Document Type


Degree Name

Doctor of Health Administration


College of Health Professions

First Advisor

Kit N. Simpson

Second Advisor

Kirstin Gros

Third Advisor

Jillian B. Harvey

Fourth Advisor

Daniel Brinton

Fifth Advisor

Zoher F. Kapasi


The Agency for Healthcare Research and Quality (AHRQ, 2014) defines Disruptive Behavior (DB) as any behavior that shows disrespect for others or any interpersonal interaction that impedes the delivery of patient care. The objective of this study was to identify work impact and costs of patient disruptive behaviors (DB) at a VAMC facility. DB events were separated into cost strata to help healthcare administrators understand the economic impact of disruptive behavior on costs. This study describes the impact of work unit frequency and severity of patient disruptive behaviors on lost days due to injury, absences, and employee turnover. Secondly, the impact of disruptive behavior in productivity and resource cost was estimated using estimated cost weights for staff hiring costs, staff lost duty days cost, staff coverage and light duty costs, overtime and compensatory time costs, and loss of clinic time. Archival injury incident data was used to explore the relation between frequency and severity of incidents on work unit. An economic modeling approach was executed in Microsoft Excel to aggregate cost estimates and to display the effect of variations in costing assumptions on global cost of DB. The results of the model showed that the largest contributor to cost is compensation and the second largest is direct medical care expenses. Thus, these should be targeted first for interventions.


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