Your post on behaviors that undermine cultures of safety is both thought provoking and well articulated. Consequently, the American College of Obstetricians and Gynecologists published an article with key elements of these behaviors, obstacles for improvement along with recommendations. The article coincides with your discussion posts in that it explains these behaviors as being disruptive displace of intimidation and unprofessionalism. Unfortunately, some employees are reluctant to report such behavior for free of retaliation. In other instances, hospital or medical organizations may overlook the behaviors due to the possibility of loss revenue. For examples, doctors exhibiting hostile behaviors are not reprimanded because of their status. However, the Joint Commission requires hospitals to establish codes of conduct that include addressing intimidating and disruptive behaviors. Joint Commission requires the education of staff on policies regarding the intolerance of these behaviors and the no punishment protective response for reporting as this behavior decreases the culture of safety. Courses on professional competence have been suggested to improve behaviors. These courses often include communication, technical and clinical reasoning skills. Other aspects of the professionalism competence is its emphasis on potential consequences for behavior that does not represent a culture of safety. Actions to assist in adherence includes blind surveys regarding management and doctors behaviors. The anonymity of the process increases feedback and allows for corrective action. However, as some workers are convinced that the integrity of the anonymous surveys are compromised data may be skewed.