Transcript Creating Healthy Chapter Work Environments

Creating Healthy Chapter
Work Environments
Rose Shaffer RN, MSN, CRNP-BC, CCRN
President
SePA Chapter AACN
2005-2006
Cardiology Nurse Practitioner
Thomas Jefferson University Hospital
Philadelphia, PA
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Thank You
AACN’s Healthy Work
Environment Standards
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In 2001, AACN made a commitment to
actively promote the creation of healthy
work environments that support and
foster excellence in patient care
wherever acute and critical care nurses
practice
In 2005 the healthy work environment
standards were published
AACN Healthy Work
Environment Standards
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The healthy work environment (HWE)
standards uniquely identify behaviors
that are often discounted, despite the
evidence that they (contribute to
creating unsafe conditions and)
obstruct the ability of individuals and
organizations (chapters) to achieve
excellence
AACN Healthy Work
Environment Standards
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Skilled Communication
True Collaboration
Effective Decision Making
Appropriate Staffing
Meaningful Recognition
Authentic Leadership
The Evidence for HWE
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There is evidence that
unhealthy work environments
contribute to (medical errors,
ineffective delivery of care and)
conflict and stress among health
professionals
Consider These Potential
Hospital Examples:
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A night nurse chooses not to call a
physician known to be verbally abusive.
She uses her judgment to clarify a med
order and administers a fatal dose of the
wrong drug
Isolated decision making in one
department leads to tension and frustration
Nurses are placed in leadership positions
without preparation and support
Do each of these situations
characterize poor and
ineffective relationships or
actions within hospitals?
Why Care About the
Chapter Work Environment?
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Unhealthy chapter work environments
can also lead to conflict and stress
among board members, committee
chairs and chapter members, as well
as any one else involved in the
organization and therefore the
important work of the chapter may not
be accomplished!
Consider These Potential
Chapter Examples:
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A board member or committee member
chooses not to address an individual on the
committee who is verbally abusive or berating
There is isolated decision making by certain
individuals on a committee or the board
Individuals are placed in leadership positions
without adequate preparation and support for
their role
Do each of these situations
characterize poor and
ineffective relationships or
actions within the chapter?
Organizational Health
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“An organization is not its products,
markets or technologies. Rather it is in
the repetitious patterns of how people
relate to each other, gather and interpret
information, solve problems, make
decisions, manage conflict and
implement change while accomplishing
the organization’s purpose.”
Bushe, GR. Clear Leadership; 2001
Organizational Health
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It is important to create an organizational
culture that develops self-awareness and
consciousness of its people, including
nourishing its people with a healthy culture,
coherent policies, and effective procedures
A healthy culture exists in an organization
that listens to people and remains actively
involved in how they feel about the services
they provide
Kilman, RH Quantum Organizations:
A New Paradigm for Achieving
Organizational Success and Personal Meaning; 2001
Healthy Work Environments:
Four Key Points
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HWE do not sacrifice people at the expense
of profit
HWE do not reduce everything to cost vs.
benefit or profit vs. loss
HWE know that costs are multifaceted - they
know that profit means to make progress, not
just to make money
HWE are about moving from trapped
potential to tapped potential
Heath, J, Johanson, W, Blake, N.
Healthy Work Environments: A Validation
of the Literature; Journal of Nursing Administration; 2004
“There is no power greater
than a community discovering
what it cares about.”
Margaret Wheatley
Organizational change and
management author,
International educator
AACN’s Commitment
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AACN is committed to creating
work environments that are safe,
(healing), humane and respectful of
the rights, responsibilities, needs
and contributions of all people,
including patients, their families and
nurses
Chapter Commitment
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Chapters are committed to creating
a chapter work environment that is
safe, humane and respectful of the
rights, responsibilities, needs and
contributions of all chapter
members within the organization
Standard #1:
Skilled Communication
Chapter leaders
must be (as)
proficient in
communication
skills (as they are
in clinical skills)
“We cannot be truly human
apart from communication… to
impede communication is to
reduce people to the status of
things”
Paulo Freier
International Educator
Community Activist
Communication Techniques
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E-mail
Instant Messaging
Voice Mail
Video Conferencing
Telephone
Face to face
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Verbal
Non-verbal
(including silence)
Skilled Communication
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It is more than a one-way delivery of
information…..it is a two-way dialogue
in which people think and decide
together
Chapters must make a priority to
develop communication skills among it’s
members - including written, spoken,
electronic and non-verbal skills (that are
on par with expert clinical skills)
Skilled Communication
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Intimidating behavior and deficient
interpersonal relationships lead to
mistrust, chronic stress and
dissatisfaction among committee
members…… which may lead to
unhealthy situations that contribute to
nurses leaving the chapter (their
position and sometimes the profession).
Skilled Communicators……
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Focus on finding solutions and achieving
desirable outcomes
Seek to protect and advance
collaborative relationships among
colleagues
Invite and hear all relevant perspectives
Call upon goodwill and mutual respect to
build consensus and arrive at common
understanding
Skilled Communicators……
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Demonstrate congruence between
words and actions, holding others
accountable for doing the same
Have access to appropriate
communication technologies and are
proficient in their use
The (Healthcare)
Organization (Chapter)
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Establishes zero-tolerance policies and
enforces them to address and eliminate
abuse and disrespectful behavior in the
chapter
Establishes structures and processes that
ensure effective information sharing
among (patients, families and healthcare)
committee members and the membership
The (Healthcare)
Organization (Chapter)
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Establishes systems that require
individuals and teams to evaluate the
impact of communication on (clinical),
financial and work environment outcomes
Team members demonstrate skilled
communication to qualify for professional
advancement (leadership positions within
the chapter)
“It is ethical to request,
encourage and deliver feedback
on all facets of individual and
organizational performance. It is
unethical to ignore, discourage or
fail to give feedback.”
David Thomas
Ethicist
Ethics of Choice Training Program
Standard #2:
True Collaboration
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Chapter leaders
must be
relentless in
pursuing true
collaboration
“It is ethical to be open to the
possibility that your view is
incomplete and therefore capable
of revision. It is unethical to ignore
information that could allow you
and/or your organization to grow.”
David Thomas
Ethicist
Ethics of Choice Training Program
True Collaboration
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It is a process, not an event
It must be ongoing and built over time,
eventually resulting in a work culture
where communication and decision
making between nurses….. and among
nurses themselves becomes the norm
With true collaboration, the unique
knowledge and abilities of each
committee member are respected…….
True Collaboration
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Requires skilled communication, trust,
knowledge, shared responsibility,
mutual respect, optimism, and
coordination, which are integral to
successful collaboration
Requires constant attention and
nurturing……
Every Committee Member….
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Embraces true collaboration as an
ongoing process and invests in its
development to ensure a sustained
culture of collaboration
Acts with a high level of personal
integrity
Demonstrates competence appropriate
to his/her role and responsibilities
Every Committee Member….
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Contributes to the achievement of
common goals by giving power and
respect to each person’s vote,
integrating individual differences,
resolving competing interests and
safeguarding the essential contribution
each must make in order to achieve
optimal outcomes
The (Healthcare)
Organization (Chapter)
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Creates, uses and evaluates processes
that define each committee member’s
accountability for collaboration and how
unwillingness to collaborate will be
addressed
Makes available the time needed to
resolve disputes
“We are different so that we can
know our need of one another,
for no one is ultimately selfsufficient. A completely selfsufficient person would be subhuman.”
Archbishop Desmond Tutu
Civil rights activist
Nobel Laureate
Standard # 3:
Effective Decision Making
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Chapter leaders
must be valued and
committed partners
in making policy,
(directing and
evaluating clinical
care) and leading
organizational
operations
“Individuals and organizations
learn and evolve through
conscious, deliberate action.
Deliberate action is ethical. When
the time to act has come, it is
unethical not to do something.”
David Thomas
Ethicist
Ethics of Choice Training Program
The (Healthcare)
Organization (Chapter)
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Clearly articulates organizational values
and committee members incorporate
these values when making decisions
Establishes systems………..to facilitate
data-driven decisions
Provides chapter members with support
for and access to ongoing education
focusing on strategies to assure
collaborative decision making
The (Healthcare)
Organization (Chapter)
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Establishes deliberate decision making
processes that ensure respect for the
rights of every individual, incorporate all
key perspectives and designate clear
accountability
Has fair and effective processes in place
at all levels to objectively evaluate the
results of decisions, including delayed
decisions and indecisions
“People will not believe in an
organizational change effort
unless they have the opportunity
to plan it, experience it, provide
feedback, and own it.
Involvement supports and
sustains motivation, the essential
ingredient for change.”
Robert F. Allen
Advocate for cultural change and wellness
Standard # 4:
Appropriate Staffing
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Staffing must ensure
the effective match
between (patient)
needs and (nurse)
competencies
Appropriate Staffing
of Committees
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Chapter leaders must ensure the
effective match between the needs
and desires of volunteers who want
to join a committee
There must be enough people on
committees and those people should
attend meetings regularly
The (Healthcare)
Organization (Chapter)
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Has policies in place that are solidly
grounded in ethical principles and
support the professional obligation of
nurses to do the work of the chapter
Standard # 5:
Meaningful Recognition
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Chapter leaders
must be recognized
and must recognize
others for the value
each brings to the
work of the
organization
“Treat people as if they were
what they ought to be, and help
them to become what they are
capable of being.”
Johann Wolfgang von Goethe
Philosopher, poet, playwright
Committee Members
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Understand that everyone is
responsible to (play an active role
in the organization’s recognition
program and) meaningfully
recognize contributions of others
The (Healthcare)
Organization (Chapter)
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Has a system in place………that
ensures a……… focus on recognizing
all committee members for their
contributions and the value they bring
to the work of the organization
Has a recognition system that reaches
from the committee level (bedside) to
the board room, ensuring individuals
receive recognition……..
“It is ethical to offer feedback to those
from whom you or your organization
receive services. It is unethical to allow
outstanding performance to go
unacknowledged … just as it is unethical
not to provide feedback to those whose
performance or service threatens the
optimal performance of your
organization.”
David Thomas
Ethicist
Ethics of Choice Training Program
Standard # 6
Authentic Leadership
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Chapter leaders
must fully embrace
the imperative of a
healthy work
environment,
authentically live it
and “ENGAGE”
others in it’s
achievement
“Managers assume that job security is of
paramount importance to employees.
Among workers, however, it ranks far
below desire for respect, a higher
standard of management ethics,
increased recognition of employee
contributions, and closer, more honest
communication between employees and
senior management.”
Robert H. Rosen
Psychologist, Business Author,
MacArthur Foundation Fellow
Chapter Leaders…..
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……successfully translate the vision of
a healthy work environment
Excel at generating …. enthusiasm for
achieving the standards that create and
sustain healthy chapter work
environments
Role model skilled communication, true
collaboration, effective decision making,
meaningful recognition and authentic
leadership
The (Healthcare)
Organization (Chapter)
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Provides support for and access to
educational programs to ensure that
chapter leaders develop…….skilled
communication, effective decision
making, true collaboration, meaningful
recognition…….
The (Healthcare)
Organization (Chapter)
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Ensures chapter leaders…… participate
in key decision making…..have access
to essential information and the
authority to make necessary decisions
Provides a (formal) co-mentoring
program for all chapter leaders - chapter
leaders actively engage in the comentoring program
“One of the most decisive
functions of leadership is the
creation, management, and when
necessary, the destruction and
rebuilding of culture.”
Edgar Schein
Organizational behavior and culture
pioneer
The Six Standards…..
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Represent evidence-based and
relationship-centered principles of
professional performance
Are designed to be used as a
foundation for thoughtful reflection and
engaged dialogue about the current
realities of each work environment,
including chapter work environments
What are the Benefits of a
Healthy Chapter Work
Environment?
Some Benefits of
Chapter HWE’s
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Better communication; less frustration
among committee members/chairs
Collaborative relationships, group
cohesiveness, & authentic leadership
resulting in a “can do” attitude to
ensure the survival of the chapter
Efficiency and productivity in decision
making and the work of the chapter
Some Benefits of
Chapter HWE’s
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Increased respect for others opinions
More satisfied committee members
who may “spread the word” of the
chapter, thereby potentially
increasing membership and future
leadership in the chapter
Other benefits???
Questions?