Tips for moving workplace to culture of respect

First step is to deal with problem workers

Many hospitals and other employers are moving toward a fair and respectful culture in which there is no tolerance for rude supervisors and annoying coworkers.

"It ties into preventing violence in the workplace and providing inclusion training," says Lindsey R. Kelley, PharmD, MS, manager of pharmacy operations at UPMC Presbyterian Shadyside in Pittsburgh, PA.

"Inevitably there might always be that one [annoying] person in the workplace," she adds. "But we're getting better as a field at looking at how we handle that person."

Kelley offers these strategies for improving staff relations and working toward a fair and respectful workplace culture:

• Identify and deal with problem employees: Pharmacy leaders need to identify and deal with staff members who are not aligned with the department's goals and culture. In other words, they need to find the bad eggs and make changes before staff morale suffers.

"This is one of the most difficult things you can do," Kelley says.

One approach is to find out what motivates an employee who has workplace problems.

"Is there something going on outside of the workplace and they're distracted?" she says. "Or is it something within the workplace, something that leaves them feeling disengaged?"

Kelley works with her own staff to find out what they're interested in regarding their profession and work, and then she uses this to help motivate improvement.

"We're trying to get employees back to the fact that they got into pharmacy for a reason," she explains. "What is their reason, and how do we tie back to what they do to engage their passion?"

It also helps to have conversations with staff about creating home-work boundaries when their home life has a negative impact on their work attitude.

"You can say, 'I understand what's going on at your home, but when we come to work we have to find a way to keep the frustration from affecting everyone you work with,'" Kelley says. "We need to go back to the team mentality, putting the patient as a first priority and remembering that every minute we spend being grumpy takes away from our patient care."

• Improve interdisciplinary teamwork and communication: Some universities are training fledgling health care professionals in how to develop a culture of fairness and respect.

"One example of this is at the University of Minnesota where they have an interdisciplinary course with first year pharmacy medicine and other medical fields all attending," Kelley says. "They focus on this idea of interdisciplinary teamwork and communication."

The class has students watch a video showing an example of poor communication that puts the patient at risk.

"There's a physician leader, a surgeon, who is giving commands, and the nurse is uncomfortable, but is not saying anything," Kelley explains.

"The class shows these examples to teach empowerment to all members of the team and to say to all of them that they have a right to say, 'I don't feel comfortable with this,' or 'I don't like where this is going,'" she adds.

The point is that hospitals can have team leaders, but each member of the team should feel comfortable with disagreeing, particularly as it relates to a safety issue, she says.

"An employee needs to engage a supervisor and say, 'I'm uncomfortable with this,'" Kelley says. "Then together you work toward a solution."

• When an employee is not going to change, it's time to make a change: The employee whose work is below par or whose attitude is unpleasant might be able to improve given the right motivation.

"This could mean helping the person find a job that they don't find boring," Kelley says.

Or maybe the person is doing a very good job in some ways but is failing to document or meet one or more of the job goals. The conversation in this case might center on praising the employee for what he or she does right but asking the person to pick it up in this one area.

"You could say, 'These are the things that will make you a better performer,'" Kelley says. "You could say, 'You scored this on the merit piece, but you could have scored this if you'd done these things.'"

In some cases, it might be time to part ways.

The book Good to Great: Why Some Companies Make the Leap ... and Others Don't, written by Jim Collins and published in 2001, makes the point that a workplace is like a bus that has a mission and vision, Kelley notes.

"If people believe in your mission and vision then they're on the right bus, and it's just a matter of finding the right seat for them," she says. "But there might be people who are on the wrong bus and who don't believe in the same mission and vision as your health system, and you have to help them come to the realization that there might be somewhere else they'd be happier working."

These conversations are never easy, but the best approach is to be calm and direct.

"You can say, 'Your performance is a solid average, and your attitude is not where it needs to be,'" Kelley suggests. "Or to a strong performer, you can say, 'You're a good clinician, but your attitude does not align with our departmental goals and our departmental values."

A supervisor can hope an employee will come to this realization on his or her own, but it's also likely that a frank conversation will be needed.

"Sometimes people feel like they're doing a good job, but they have the wrong expectation about what they're doing," Kelley says. "So before you take any punitive or disciplinary measures, you need to make sure the two of you have the right idea of what you're working toward and what are the expectations."