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Monitoring the health of the work environment with a daily assessment tool: the REAL – Relative Environment Assessment Lens – indicator

Published online by Cambridge University Press:  01 October 2015

Karen E. Hinsley ,
Audrey C. Marshall ,
Michelle H. Hurtig ,
Jason M. Thornton ,
Cheryl A. O’Connell ,
Courtney L. Porter ,
Jean A. Connor  and
Patricia A. Hickey
Karen E. Hinsley*
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America
Audrey C. Marshall
Affiliation:
Department of Cardiology, Boston Children’s Hospital, Boston, Massachusetts, United States of America Harvard Medical School, Boston, Massachusetts, United States of America
Michelle H. Hurtig
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America
Jason M. Thornton
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America
Cheryl A. O’Connell
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America
Courtney L. Porter
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America
Jean A. Connor
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America Harvard Medical School, Boston, Massachusetts, United States of America
Patricia A. Hickey
Affiliation:
Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, Boston, Massachusetts, United States America Harvard Medical School, Boston, Massachusetts, United States of America
*
Correspondence to: K. E. Hinsley, BSN, RN, CCRN, Cardiovascular and Critical Care Services, Department of Nursing Patient Services, Boston Children’s Hospital, 300 Longwood Ave, Boston, MA 02115, United States of America. Tel: 617-355-7046; Fax: 617-739-5022; E-mail: Karen.Hinsley@cardio.chboston.org
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Abstract

Background

Evidence shows that the health of the work environment impacts staff satisfaction, interdisciplinary communication, and patient outcomes. Utilising the American Association of Critical-Care Nurses’ Healthy Work Environment standards, we developed a daily assessment tool.

Methods

The Relative Environment Assessment Lens (REAL) Indicator was developed using a consensus-based method to evaluate the health of the work environment and to identify opportunities for improvement from the front-line staff. A visual scale using images that resemble emoticons was linked with a written description of feelings about their work environment that day, with the highest number corresponding to the most positive experience. Face validity was established by seeking staff feedback and goals were set.

Results

Over 10 months, results from the REAL Indicator in the cardiac catheterisation laboratory indicated an overall good work environment. The goal of 80% of the respondents reporting their work environment to be “Great”, “Good”, or “Satisfactory” was met each month. During the same time frame, this goal was met four times in the cardiovascular operating room. On average, 72.7% of cardiovascular operating room respondents reported their work environment to be “Satisfactory” or better.

Conclusion

The REAL Indicator has become a valuable tool in assessing the specific issues of the clinical area and identifying opportunities for improvement. Given the feasibility of and positive response to this tool in the cardiac catheterisation laboratory, it has been adopted in other patient-care areas where staff and leaders believe that they need to understand the health of the environment in a more specific and frequent time frame.

Keywords

Healthy work environmentmeaningful recognitionskilled communicationtool measurementauthentic leadership
Type
Original Articles
Information
Cardiology in the Young , Volume 26 , Issue 6 , August 2016 , pp. 1082 - 1089
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Copyright
© Cambridge University Press 2015 

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