Abstract

Promoting civility in healthcare is necessary to provide safe, reliable, and effective patient care (Frankel et al., 2017). The consequences of incivility especially affect many aspects of care provision and are detrimental to a healthy work environment. The lasting effects of the COVID-19 pandemic have contributed to an increase of incivility in the workplace, and additional efforts to promote a culture of civility are paramount to enhancing patient care quality and staff psychological safety (El Ghaziri et al., 2022). Assessment of the work environment can reveal opportunities for improvement and more effective interventions to meet organizational needs (Harris et al., 2019). Institutional support is also necessary to ensure a culture of civility remains sustainable. This project, aiming to enhance workforce engagement where individuals are respected and valued, included development and implementation of a civility education program at a pediatric specialty care hospital in Southeast Texas. The program was developed by synthesizing best practices identified from the literature and content experts. Collaboration with representatives from human resources, performance improvement, and nursing leadership teams offered further insight into civility culture. Clark's Workplace Civility Index (WCI), a 20-item, psychometrically sound survey, was then administered to measure employee perspectives of civility in the work environment (Clark et al., 2018). It revealed areas requiring intervention, including interpersonal communication and conflict management. A project plan designed in response to results of the initial Clark's WCI was submitted to the organization's executive leadership team for feedback and to gain institutional support. With leadership's endorsement, an evidence-based educational program was developed and implemented as the method of intervention. To improve attendance, interaction, relevancy, and knowledge retention, this education was provided to staff from individual departments in a round table forum. Clark's WCI was readministered following the educational intervention. Results demonstrated, from those hospital employees participating in the civility education program, that the overall civility index increased from 90.29 to 91.14, indicating a very civil work environment. Areas identified as opportunities for improvement from the initial survey also increased, especially in two subsets: speak directly with the person with whom I have an issue and seek and encourage constructive feedback from others. A high degree of civility in the healthcare environment benefits the organization, its workforce, and the patients they serve. Consideration by healthcare leaders should be made to promote relevant interventions. Initial and ongoing work environment assessment can provide insight into areas for improvement and potential sources of incivility. Data from this project suggests that organizations should invest resources into programs that help improve interpersonal relationships and conflict management. Successful implementation requires executive support, individual understanding of civil and uncivil behaviors, and collective ownership of a culture of civility by the entire team (Garcia et al., 2021).

Description

Cultivating civility in healthcare is a necessary pursuit to maintain a healthy work environment. This abstract describes the implementation of an education-based civility project at a pediatric specialty care hospital aiming to enhance workforce engagement by promoting civility knowledge and culture.

Author Details

Clayton Edward Collins, MSN, RN, CPN and John Michael Leger, PhD, MBA, RN

Sigma Membership

Alpha Delta

Type

Presentation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Healthcare Work Environment, Incivility, Psychological Safety

Conference Name

Creating Healthy Work Environments

Conference Host

Sigma Theta Tau International

Conference Location

Austin, Texas, USA and Virtual

Conference Year

2023

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

Review Type

Abstract Review Only: Reviewed by Event Host

Acquisition

Proxy-submission

Date of Issue

2025-10-14

Click on the above link to access the slide deck.

Additional Files

Abstract.pdf (98 kB)

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Cultivating a Culture of Civility in Healthcare

Austin, Texas, USA and Virtual

Promoting civility in healthcare is necessary to provide safe, reliable, and effective patient care (Frankel et al., 2017). The consequences of incivility especially affect many aspects of care provision and are detrimental to a healthy work environment. The lasting effects of the COVID-19 pandemic have contributed to an increase of incivility in the workplace, and additional efforts to promote a culture of civility are paramount to enhancing patient care quality and staff psychological safety (El Ghaziri et al., 2022). Assessment of the work environment can reveal opportunities for improvement and more effective interventions to meet organizational needs (Harris et al., 2019). Institutional support is also necessary to ensure a culture of civility remains sustainable. This project, aiming to enhance workforce engagement where individuals are respected and valued, included development and implementation of a civility education program at a pediatric specialty care hospital in Southeast Texas. The program was developed by synthesizing best practices identified from the literature and content experts. Collaboration with representatives from human resources, performance improvement, and nursing leadership teams offered further insight into civility culture. Clark's Workplace Civility Index (WCI), a 20-item, psychometrically sound survey, was then administered to measure employee perspectives of civility in the work environment (Clark et al., 2018). It revealed areas requiring intervention, including interpersonal communication and conflict management. A project plan designed in response to results of the initial Clark's WCI was submitted to the organization's executive leadership team for feedback and to gain institutional support. With leadership's endorsement, an evidence-based educational program was developed and implemented as the method of intervention. To improve attendance, interaction, relevancy, and knowledge retention, this education was provided to staff from individual departments in a round table forum. Clark's WCI was readministered following the educational intervention. Results demonstrated, from those hospital employees participating in the civility education program, that the overall civility index increased from 90.29 to 91.14, indicating a very civil work environment. Areas identified as opportunities for improvement from the initial survey also increased, especially in two subsets: speak directly with the person with whom I have an issue and seek and encourage constructive feedback from others. A high degree of civility in the healthcare environment benefits the organization, its workforce, and the patients they serve. Consideration by healthcare leaders should be made to promote relevant interventions. Initial and ongoing work environment assessment can provide insight into areas for improvement and potential sources of incivility. Data from this project suggests that organizations should invest resources into programs that help improve interpersonal relationships and conflict management. Successful implementation requires executive support, individual understanding of civil and uncivil behaviors, and collective ownership of a culture of civility by the entire team (Garcia et al., 2021).