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Analysis

Not Just for Nurses. This Tool Evaluates the Healthcare Team's Work Environment

By Jennifer Thew RN  
   September 04, 2018

The AACN's online tool can effectively assess the health of work environments across a wide range of healthcare professions and settings.

What makes a work environment healthy? According to the American Association of Critical-Care Nurses, it's a place where healthcare professionals can make their optimal contribution. For almost a decade, critical-care nurses have been able to evaluate the health of their work environment with the association's online assessment tool based on its Healthy Work Environment standards.

Now a new study finds the tool has applications beyond critical-care, and is effective for assessing the health of the work environment for interprofessional patient care teams throughout a hospital's patient care settings.

“Although AACN’s assessment tool has been used primarily among acute and critical care nurses, our findings support consideration of wider use in multiple healthcare settings,” says Jean Anne Connor, PhD, RN, CPNP, director of nursing research, cardiovascular and critical care patient services at Boston Children’s Hospital, and the study's principal investigator. “Clinical leaders understand that to safeguard the quality of patient care, attention must be focused on the performance of healthcare teams.”

The Interprofessional Team
 

The assessment tool is an 18-question survey designed to help organizations or departments identify areas for improvement. It assists in measuring the health of a work environment against AACN's six Healthy Work Environment standards:

  • Skilled communication
     
  • True collaboration
     
  • Effective decision making
     
  • Appropriate staffing
     
  • Meaningful recognition
     
  • Authentic leadership

The study, published in the American Journal of Critical Care, reports the results of a two-phase administration of the tool to 2,621 patient-care employees at Boston Children’s Hospital.

Researchers administered the survey using a test-retest, two-stage approach. First, the AACN Healthy Work Environment Assessment Tool was administered to all healthcare team members, including:

  • physicians
     
  • nurses
     
  • social workers
     
  • therapists
     
  • clinical assistants
     
  • administrators


The first survey wave received 1,030 responses from 2,621 potential employee participants. Three weeks later, a second survey was sent to a random sample of 200 potential respondents stratified by role (physician, nurse, and others). The response rate for the second wave was 83.5%.

The results of the responses showed that the AACN Healthy Work Environments Assessment Tools is reliable and valid, supporting its use as an organizational measure.

Expanded Use
 

The Boston Children's Hospital has used the Agency for Healthcare Research and Quality’s Hospital Survey on Patient Safety Culture since 2010 to assess how employees perceive their work environment regarding patient safety. It has also administered the AACN online assessment tool to interprofessional staff in critical care and cardiovascular programs annually since 2010 and recently expanded it to an enterprise-wide assessment.

The study's results have been used in the development of measurement benchmarks and led to use of the Healthy Work Environments Assessment Tool in a nurse-led consortium of 30 cardiovascular programs in freestanding children’s hospitals.

Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.


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