All Eyes on Me: The Impact of Individualism vs. Collectivism Orientations on Justice Perceptions and Mistreatment of Frontline Staff in Emergency Departments

Mistreatment of frontline staff is a widespread issue across all industries, but is particularly prevalent in Emergency Departments (EDs). This paper examines how the orientation toward individualism vs. collectivism of outsiders—namely, patients and their escorts—affects their perceptions of justice within EDs and subsequent mistreatment of frontline staff. We conducted two field studies in major hospitals to test our hypotheses. The first study validated our model, and revealed that mistreatment was particularly likely by outsiders oriented toward individualism. The second study replicated our findings and implemented an intervention that significantly enhanced justice perceptions among these outsiders, subsequently reducing their propensity to mistreat ED staff. Our results offer new insights into the dynamics of mistreatment within EDs, emphasizing the impact of outsider expectations on their perceptions of justice and subsequent behavior.