Learn how an organization implemented an evidence based 4 phase strategy approach to eliminating incivility and bullying by cultivating a healthier workforce environment. Positive outcomes of this intervention include increased nurse engagement & satisfaction, patient/family satisfaction, and an overall healthier work environment.
To address these negative behaviors and create a foundation for professionalism, a strategic plan was developed to: 1) raise awareness of behaviors that undermine a culture of safety, professionalism, and respect; 2) utilize existing shared governance groups to establish unit-based behavioral expectations with regards to new employees, support staff, and employees from other units/departments; 3) provide front-line managers and staff with the education, training, tools, and resources to recognize, address, and eliminate disruptive behaviors to cultivate a culture of respect and professionalism; 4) augment existing curriculum for new nurses and preceptors; 5) hardwire anti-bullying and professional practice expectations through development of codes of conduct, ongoing surveillance, and zero tolerance for workplace bullying; and 6) revise existing policies and procedures to reflect disruptive behaviors, define behavioral expectations, support early identification of workplace bullying, and promote timely follow-up.
Nursing leaders within the specific unit received intensive coaching from an external consultant on strategies, tools, and resources to address disruptive behaviors. Clinical nurse champions embraced this approach as well, and continue to spearhead efforts to improve care.
The program was implemented through a four-phase strategy. Phase 1: Heighten Awareness and Recognition, Phase 2: Setting behavioral expectations and skill development. Phase 3: Build a culture that rejects incivility and promotes professional practice and Phase 4: Hardwire and sustain a new norm.
During Phase 1, the leaders were equipped with an understanding of how workplace bullying and incivility impacts their department and patient outcomes. The unit environment was assessed through baseline data collection, disruptive behaviors were identified and destabilized, coalitions with the leadership team were formed, and a sense of urgency for the work ahead was created. During Phase 2, clinical nurses identified expectations for professional behavior and were provided education and training related to common behaviors. Additionally, HWF Best Practices were infused into the unit's culture. During Phase 3, momentum was sustained by empowering nurses, recognizing role models, and building relationships. Currently, phase 4, Healthy Workforce Movement best practices are being adopted through the existing nursing councils. Additionally, the HWF initiative is currently being spread to other units and ambulatory care settings of this Magnet-recognized hospital.
Positive outcomes post implementation of this program include increased employee satisfaction, patient satisfaction and decreased bullying assessment scores.