Work nice: Program builds better work environments

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By Heather Travis
Thursday, February 10, 2011
A program developed by the U.S. Department of Veteran Affairs is helping turn a handful of Canadian hospitals into healthy work environments.
 
 
University of Western Ontario professor Heather Laschinger tested whether an intervention program developed across the border would help transform toxic work environments in Ontario and Nova Scotia hospitals into civil workplaces. The results were impressive.
 
 
University of Western Ontario professor Heather Laschinger teamed up with Michael Leiter, a professor of psychology at Acadia University in Halifax, to test whether an intervention program developed across the border would help transform toxic work environments in Ontario and Nova Scotia hospitals into civil workplaces. The results were impressive.
 
“It’s hard to provide the best care possible when you are in a stressful work environment,” says Laschinger, a Distinguished University Professor in the Arthur Labatt Family School of Nursing.
 
Health care teams are very interdependent and any issues between staff can have an impact on patient care, she says. “The whole focus of the intervention was to try to build civility, respect and engagement in the workplace.”
 
As part of its three-year project, entitled “Enhancing the Quality of Workplace Communities,” the research team implemented the U.S. Veteran Affairs-developed CREW (Civility, Respect & Engagement at Work) intervention program into five hospitals. Canadian Institutes of Health Research funded the project.
 
CREW involves a series of meetings focused on improving issues of civility, respect and work engagement. Individual hospital units would hold regular “huddles” to discuss issues in the workplace and to encourage each other to promote a positive and respectful work environment. Each unit had a trained facilitator and CREW toolkit.
 
“When people get stressed, it’s easy to snap at people,” Laschinger says. But after applying the tools of the intervention program, “some people said it made them think twice about how they are acting before they act.”
 
Within the five hospitals involved in the study, 41 units participated. The units that instituted the intervention program showed significant changes and improvements, in atmosphere compared to those units that did not have the intervention program, which stayed the same.
 
Each intervention program was directed by the units themselves, meaning they implemented strategies that worked best and were most applicable to their area, guided by a desire to make the work environment more respectful and to promote positive relationships.
 
The units using the CREW program noticed a drop in sick days, improvements in co-worker and supervisor civility, job satisfaction, trust in management, less cynicism and increased respect. Prior to the intervention, levels of incivility were strongly linked to burnout, and had mental and physical health implications, she explains.
 
When the work environment improves, so does the productivity, Laschinger notes.
 
“It’s great for the organization because whatever we can do to make the work environment more positive and empowering for people, the better. In a hospital setting it has a positive affect on patient care and outcomes,” she says.
 
The rapid pace of the increasingly competitive work environment has added stress and strain on many coworker relationships. Snide remarks, dismissive behaviour and short tempers have become normalized as part of work culture.
 
While someone might dismiss such subtle, uncivil behaviour as a person ‘having a bad day’ or ‘someone being overly sensitive,’ this is not the case. “What the research is showing is that these very subtle forms of incivility lead to all kinds of negative health outcomes,” she says.
 
“Bullying and incivility is subtle; it’s kind-of hard to nail down and be able to identify on a regular basis and deal with it,” she adds.
 
Much focus has been placed on bullying in the education system, however this doesn’t mean bullying is only a child or adolescent issue. Such behaviours are showing up in the workplace, and now often involving cyber-bullying. Ontario’s new legislation focused on workplace violence and harassment, Bill168, hopes to curb these behaviours, but there is still much that can be done to proactively address such issues.
 
The lessons reinforced by CREW are not new, Laschinger says. It is as simple as following mothers’ advice to be nice to others.
 
She sees the CREW program easily translating to workplaces beyond the health care field – it would work in any employment setting.
 
“The thing with bullying and incivility, research shows it breeds on itself. Before you know it, the whole place is a toxic environment,” she says. “Civil relationships amongst people who are working is certainly the core of a healthy work environment.”
 

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