Week 7: Workplace Environment Assessment: How healthy is your workplace?
Just as the environment is significant to patients and their families, a healthy working environment is also essential for healthcare providers. Transformational leadership is closely linked to healthcare workers’ perceptions on their environmental working conditions, involvement opportunities, meaningfulness, sense of influence, and well-being (Marshall & Broome, 2017). One may think their organization either operates seamlessly or has many issues. In most cases, there are issues that one perceives as organizational problems, while other members do not; likewise, some issues are deeper than recognized by the leaders. There are several factors and measures, which have a profound impact on organizational health. One of these factors is civility. The American Nurses Association’s Code of Ethics clearly articulates the obligation of nurses to nurture an ethical, safe, and civil workplace (Clark, 2015). Health organizations introduce policies that are designed to promote civility. Accordingly, nurses must create a sound ethical work environment and rich culture of kindness and civility by treating others with respect and dignity. Lack of civility can result in poor patient care, unsafe working conditions, and higher medical costs (Clark et al., 2011). This paper examines the use of tools used to measure the effective management of workplace civility.
The Clark Healthy Workplace Inventory is used as an evidence-based tool that aids in raising awareness, assessing the perceived organizational health, and determine the main strengths for reinforcement and weaknesses for improvement (Clark, 2017). The Clark Healthy Workplace Inventory was used to determine our workplace’s health based on the overall civility score. The inventory was completed by carefully responding to 20 statements by checking the responses that were the most accurate representation of the workplace’s perception. The total scores of the responses amounted to 82. Therefore, the assessment results are an indication that the organization is moderately healthy based on the overall civility score. In the last two years, there have been drastic changes in our organizational leadership. The work environment assessment results reflect the ongoing negative changes brought forth by the new leaders in our organization.
One of the most surprising things about the results was the lack of clear and visible levels of low trust among and between formal leaders and other organizational members. Another surprising thing is the lack of direct, transparent, and respectful communication across all organizational levels. One of the ideas that were evident before completing the assessment is the promotion of teamwork and collaboration among the nursing teams. Our organization has a strong mentorship and coaching program that embraces a teamwork approach to healthcare delivery, which ensures that all patients are satisfied in their healthcare encounters. This is evidenced by effective communication skillset and collaborative healthcare coordination in the wards, where we are encouraged to pose questions, share concerns, present opinions, and deliberate potential solutions. The assessment confirmed that strong teamwork and effective collaboration among team members are vital strengths and skills that can be used to accomplish and enhance workplace satisfaction and provide optimal patient experience.
The results of the Clark Workplace Inventory suggest that our organization is a moderately healthy working environment. Based on the results, the organization’s new leaders should focus on transforming and growing the civility score from 82 to more than 90 that indicates a very healthy workplace. The main improvement areas include improving the trust levels between formal leadership and other organizational members and elevating and maintaining direct, transparent, and respectful communication across all organizational levels. As a result, this will increase the workplace civility score and overall health of the organization.
Different theories can be used in structuring the civility conversations. According to Clark (2015), the DESC theoretical model that is part of TeamSTEPPS is one of the evidence-based teamwork systems used to improve teamwork and communication skills, improving the safety and quality of healthcare. The DESC model, together with cognitive rehearsal, can be employed as an effective method of addressing specific incivility incidents. Cognitive rehearsal is an evidence-based method where learner practices addressing workplace incivility in non-threatening environments with skilled facilitators (Griffin, & Clark, 2014). The unique combination of cognitive rehearsal, simulations, scripting, thoughtful practice, and probing can prepare nursing students in addressing uncivil encounters (Clark, 2019). The theory is related to the Work Environment Assessment results. It leads to a healthy work environment with a mutual organization’s vision, values, and norms of the teams, a higher level of civility, and emphasis on formal and informal leadership and civility conversations across all organizational levels.
Nurses have an ethical and professional obligation to nurture civility and healthy working environments to protect patients’ safety. The organization can apply the DESC theory to improve organizational health and create strong working teams. The DESC model has four main elements: Describing the specific situations, expressing concerns, stating other alternatives, and consequences. It can be applied in difficult conversations, whenever the emotions and stakes are high, and increased defensiveness. One’s response may derail the best intentions. The DESC tool can assertively decrease defensiveness, thereby enhancing communication and increasing teamwork. In the long-run, the subsequent Work Environment Assessment scores for the evidence and promotion of teamwork and collaboration and transparent, direct, and respectful communication across all organizational levels will both increase to five. Thus, the organizational civility score will increase to 91, which designates a very healthy workplace.
References
Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse Leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. http://doi:10.1097/NNA.0b013e31822509c4
Clark, C. M. (2017). Creating & sustaining civility in nursing education. Sigma Theta Tau International.
Clark, C. M. (2018). Combining cognitive rehearsal, simulation, and evidence-based scripting to address incivility. Nurse Educator, 44(2):64-68. http://doi:10.1097/NNE.0000000000000563.
Clark, C. M. (2015). Conversations to inspire and promote a more civil workplace. American Nurse Today, 10(11), 18–23. Retrieved from https://www.americannursetoday.com/wp-content/uploads/2015/11/ant11-CE-Civility-1023.pdf
Griffin, M., & Clark, C. M. (2014). Revisiting cognitive rehearsal as an intervention against incivility and lateral violence in nursing: 10 years later. Journal of Continuing Education in Nursing, 45(12), 535–542. http://doi:10.3928/00220124-20141122-02
Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader. Springer.