The potential costs of disruptive behaviors have been calculated in the following ways by Rosenstein:

I. Recruitment and retention
• RN: $60 000 to $100 000/ additional opportunity costs
The cost of replacing a physician can be high. In some cases between $500,000-$,000,000 - OR MORE!

II. Adverse events (“No pay” for adverse events initiatives)
• Medication error: $2000 to $5800 per case; additional increased length of stay (LOS) 2.2-4.6 days
• Hospital-acquired infection: $20 000 to $38 500
• Deep vein thrombosis: $36 000; additional increased LOS 4.2 days
• Pressure ulcer: $22 000; additional increased LOS 4.1 days
• Ventilator-associated pneumonia: $49 000; additional increased LOS 5.3 days

III. Malpractice: $521 560/ additional opportunity costs

IV. Fines: $25 000 to $100 000

V. Patient satisfaction, hospital reputation, market share implications

VI. Compliance issues
• Impact on documentation and coding
• Impact on use efficiency (LOS, resource efficiency, discharge planning)
• Impact on staff responsibilities (medical records completion, on call, meeting attendance)
• Impact on quality (availability, responsiveness)

VII. Administrative issues
• Impact on productivity and efficiency (nonproductive activities, waste, delays, absenteeism)
• Impact on staff morale and satisfaction
( from Rosenstein, A. H. (2011). The quality and economic impact of disruptive behaviors on clinical outcomes of patient care. American journal of medical quality : the official journal of the American College of Medical Quality, 26(5), 372–379. doi:10.1177/1062860611400592)