Interprofessional Organizational and Systems Leadership

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Work Environment Assessment Template

Workplace Environment Assessment .

Summary of Results - Clark Healthy Workplace Inventory	The result of the Work Environment Assessment reveals are workplace that is very unhealthy and uncivil. This unhealthy workplace result is influenced by one’s perception and scoring. The total score was 34, informed by leadership ineffectiveness in different domains or variables. It was clear that based on my experience as a novice nursing graduate at this facility, and the current state of affairs, not much has changed in terms of organizational culture and climate. Key areas of concern include the lack of organizational culture assessment and improvement of the culture, absence of mentoring and proper preceptorship programs for new employees. Also, there is a significant absence of shared governance and decision-making. There is no adequate resources and opportunities for professional development and growth. It is a confirmation that the organization does not position itself as one that attracts and retains the best nurses. There is a need for change in leadership behaviors and actions that demonstrate inclusivity, respect, collaboration, training, and workplace safety/improvement.
Identify two things that surprised you about the results. Also identify one idea that you believed prior to conducting the Assessment that was confirmed.	The two surprises are the unhealthy state of the organization based on the score and its culture that has remained unchanged. One idea believed about the organization is that employees are not treated as assets and valued partners within the organization. What is said in the vision and mission statement as well as employee policy statements do not reflect in practice.
What do the results of the Assessment suggest about the health and civility of your workplace?	The overall result tends to confirm the perception held before the assessment. The meaning of the result is that leadership in this organization is not effective from the employee/author's perspective. There is a need for a leadership change and development in the organization to reflect the vision, mission, culture of the organization. Transformational leadership ideals/principles need to be part of the organization to improve productivity, quality care, and satisfaction among staff and patients.
Briefly describe the theory or concept presented in the article(s) you selected. Explain how the theory or concept presented in the article(s) relates to the results of your Work Environment Assessment.	The concept presented in the selected article is cognitive rehearsal (CR). It is an effective teaching and learning framework that can be used to address incivility in the workplace. It entails the use of individual cognitive elements in information intake and processing. By listening to someone or reading instructions, people can respond by changing their behaviors and how they respond to messages that suggest incivility. Cognitive rehearsal helps individuals to use their thought process in preserving and analyzing information. Clark (2015) states that CR includes "didactic and interactive learning and instruction, rehearsal of specific phrases to use during uncivil encounters; and practice sessions to reinforce instruction and rehearsal" (p. 21). The result of the work environment assessment indicates a very unhealthy and uncivil workplace. In light of the result, the concept of cognitive rehearsal is able to teach nurses and other healthcare professionals on how to address incivility in their workplaces. The organizational culture is not assessed and improved, preventing the organization from becoming a learning organization that improves on its vision and mission. Thus, teaching nurses and staff on techniques to identify and respond to behaviors, words, and policies that make an organization healthy is the relationship between the concept and the result of the Work Environment Assessment. The leaders are not intentional in measuring employee satisfaction and engagement.
Explain how your organization could apply the theory highlighted in your selected article(s) to improve organizational health and/or create stronger work teams. Be specific and provide examples.	A learning culture seems to be absent in the organization. Leaders at all levels need to develop a learning culture that is focused on improving interprofessional relationships and collaboration. Also, continuing education and learning while working is needful. There are relational and communication issues that need to be addressed from the leadership level. Evidence exists to show that cognitive rehearsal improves communication and reduces incivility in organizations (Clark, 2019; Kile, Eaton, deValpine, & Gilbert, 2018). The organization needs to empower either a nurse leader/educator and an interprofessional team to undertake the implementation of cognitive rehearsal with a focus on improving the health of the organization. Staff needs to be equipped with the skills to identify and respond to both verbal and nonverbal forms of communication. The interprofessional team should be able to provide continuous leadership development programs that integrate cognitive rehearsal. This will improve camaraderie, workplace safety, civility, collaboration, and satisfaction.
General Notes/Comments	References Clark, C. M. (2019). Fostering a culture of civility and respect in nursing. Journal of Nursing Regulation, 10(1), 44–52. doi:10.1016/s2155-8256(19)30082-1 Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2018). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543–552. doi:10.1111/jonm.12709

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Workplace Environment Assessment

The structure, culture, climate and leadership is needed for a productive and high-performing institutions. Successful management provides workers with a healthy working atmosphere. In a healthy and efficient institution, the guiding principles span different areas. Employment turnover, lack of moral and increased healthcare costs is related to unsafe, antagonistic working environments.

Leadership actions significantly contribute to an organization's wellbeing. This paper will explain the results of my work environment assessment, a review of literature and evidence based strategies to create a high performance interprofessional team.

Part 1: Work Environment Assessment

A method to determine the civility and wellbeing of an organization is used as a tool in Clark Healthy Workplace Inventory. The assessment tool uses a number scale of 1-5, to score statements, five being true and 1 being untrue. The sum total from the questions represents the civility score within the organization. The total civility score ranges from 20-100. "The ranking from 90 to 100 represents a very safe place to work; 60 to 89 indicate fairly healthy; 70 to 79 suggest a mildly healthier position; 60 to 69 indicate a marginally healthy place to work; 50 to 59 indicate a very unhealthy situation; (Clark, 2015, p.20). This addresses problems of reverence for a common vision, trust, respect and effective communication between leaders and employees. The work environment assessment also comprises satisfaction of the employees, salary systems, shared governance, decision-making, team promotion, collaboration and the well-being of staff.

Description of Work Environment Assessment

My place of work scored a 89 or very healthy using the Clark Healthy Workplace Inventory (Clark, 2015). My hospital scored high due to the fact that there is tremendous coordination among the hospital units such as one unit is will help out another unit if they are short staffed. We also have leadership assistance in emergencies situations. Also, there is a significant absence of shared governance, decision-making, policy development, reviews, and revisions. There is no adequate resources and opportunities for professional development and growth. It is a confirmation that the organization does not position itself as one that attracts and retains the best nurses and one will not be inclined to recommend the place to friends and family.

Two Surprises and Meaning of Assessment Result

The two surprises are the unhealthy state of the organization based on the score and its culture that has remained unchanged. One idea believed about the organization is that employees are not treated as assets and valued partners within the organization. The overall result confirmed this idea because there were several checked boxes on the “completely untrue” scale component. The meaning of the result is that leadership in this organization is not effective from the employee/author's perspective. There is a need for a leadership change and development in the organization to reflect the vision, mission, culture of the organization. Transformational leadership ideals/principles need to be part of the organization to improve productivity, quality care, and satisfaction.

Part 2: Reviewing the Literature

The concept presented in the selected article is a cognitive rehearsal. It is an effective teaching and learning approach that can be used to address incivility in the workplace. It entails the use of individual cognitive faculty in information intake and processing. By listening to someone or reading instructions, people can respond by changing their behaviors and how they respond to incivility. Cognitive rehearsal helps individuals to use their thought process in preserving information. As stated by Clark (2015), it includes "didactic and interactive learning and instruction, rehearsal of specific phrases to use during uncivil encounters; and practice sessions to reinforce instruction and rehearsal" (p. 21). Usually, a cue is given time because it is being processed and responded to according to what is learned.

The result of the work environment assessment indicates a very unhealthy and uncivil workplace. In light of the result, the concept of cognitive rehearsal teaches nurses and other healthcare professionals on how to address incivility in healthcare organizations. The organizational culture is not assessed and improved, preventing the organization from becoming a learning organization that improves on its vision and mission. Thus, teaching nurses and staff on techniques to identify and respond to behaviors, words, and policies that make an organization healthy is the relationship between the concept and the result of the Work Environment Assessment.

Leaders need to develop and implement a learning culture in the organization. Continuing education and learning at the organization is needful. Evidence exists to show that cognitive rehearsal improves communication and reduces incivility in organizations (Clark, 2019; Kile, Eaton, deValpine, & Gilbert, 2018). The organization needs to empower either a nurse leader, educator, and an interprofessional team to undertake the implementation of cognitive rehearsal with a focus on improving the health of the organization. Staff needs to be equipped with the skills to identify and respond to both verbal and nonverbal forms of communication. The interprofessional team should be able to provide continuous leadership development programs that integrate cognitive rehearsal. This will improve camaraderie, workplace safety, civility, collaboration, and satisfaction.

Part 3: Evidence-Based Strategies to Create High-Performance Interprofessional Teams

Building trust by the leadership is one strategy that can be implemented to address any shortcomings revealed in the Work Environment Assessment. Trust is essential to work confidence, satisfaction, and desire to continue working in an organization (Linzer et al., 2019). When the healthcare team operates in a trusting environment, there is shared success as well as a reduction in stress or burnout. Collaboration increases in an environment of trust. Another strategy is to improve working conditions that will inspire staff and attract best and competent personnel. A climate of safety is beneficial to clinicians and patients because of improvement in patient outcomes as well as staff satisfaction (Wagner et al., 2019).

The organization needs a culture of joint-decision making where inputs from other members of staff contribute to issues that impact their work and relationships. Therefore, one will recommend a change in governance and leadership actions whereby leaders make decisions without considering that other personnel are stakeholders in the delivery of care. Policy development should integrate views from colleagues in the healthcare team. This strategy will promote commitment and shared governance which is shown to improve care and performance (Kutney-Lee et al., 2016). Implementing this strategy will cause nurses in the organization and others to feel engaged as partners.

Interprofessional training and creation of professional development opportunities are areas that should be implemented to equip clinicians with the knowledge, skills, and behaviors that foster collaboration and growth. When an organization encourages and promotes teamwork, collaboration, and continuing education opportunities for its personnel, these actions are likely to boost efficiency, improvement in the quality of care, and overall staff and patients' satisfaction. Effective interprofessional collaboration and communication improve patients' outcomes (Kreps, 2016; Mayo & Woolley, 2016). Thus, if these two strategies are implemented, the delivery of care and the health of the organization will be bolstered.

References

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

Clark, C. M. (2019). Fostering a culture of civility and respect in nursing. Journal of Nursing Regulation, 10(1), 44–52. doi:10.1016/s2155-8256(19)30082-1

Kile, D., Eaton, M., deValpine, M., & Gilbert, R. (2018). The effectiveness of education and cognitive rehearsal in managing nurse‐to‐nurse incivility: A pilot study. Journal of Nursing Management, 27(3), 543–552. doi:10.1111/jonm.12709

Kreps, G. L. (2016). Communication and effective interprofessional health care teams. International Archives of Nursing and Health Care 2:051. doi: 10.23937/2469- 5823/1510051

Kutney-Lee, A., Germack, H., Hatfield, L., Kelly, S., Maguire, P., Dierkes, A., Del Guidice, M. & Aiken, L. H. (2016). Nurse engagement in shared governance and patient and nurse outcomes. Journal of Nursing Administration, 46(11), 605–612. doi:10.1097/nna.0000000000000412

Linzer, M., Poplau, S., Prasad, K., Khullar, D., Brown, R., Varkey, A., Yale, S., Grossman, E., Williams, E., & Sinsky, C. (2019). Characteristics of health care organizations associated with clinician trust. JAMA Network Open, 2(6), e196201. doi:10.1001/jamanetworkopen.2019.6201

Mayo, A. T., & Woolley, A. W. (2016). Teamwork in health care: Maximizing collective intelligence via inclusive collaboration and open communication. AMA Journal of Ethics, 18(9), 933–940. doi:10.1001/journalofethics.2016.18.9.stas2-1609.

Wagner, A., Rieger, M. A., Manser, T., Sturm, H., Hardt, J., Martus, P., Lessing, C., & Hammer, A. (2019). Healthcare professionals’ perspectives on working conditions, leadership, and safety climate: a cross-sectional study. BMC Health Services Research, 19(1). doi:10.1186/s12913-018-3862-7