Knowledge Exchange

CREW - Civility, Respect and Engagement at Work

Contact Information

Lisa Speigel
Research Manager
The Centre for Organizational Research and Development
Acadia University
All settings
Wolfville, Nova Scotia
lisa.speigel@acadiau.ca

When was your practice implemented?
September 2008

Describe the issue that prompted the implementation of your practice:
Incivility. Incivility in the workplace has become a rising problem. Incivility in a healthcare setting can cause decreased patient satisfaction, put patient care at risk, and create a negative work environment for employees themselves. To work toward a solution to this problem, the CREW program was adapted and designed to fit the needs of Canada's health care system.

Describe your practice:
The CREW (Civility, Respect and Engagement at Work) program is designed to identify issues of incivility at work and address them head on. Work groups meet on a regular basis for 6 months to discuss issues of teamwork, civility and engagement with their coworkers. Groups are led by an on-site facilitator who has been trained in facilitation and the CREW process. CREW Canada trains facilitators to lead groups within their organization and provides on-going support for them during the process. Units involved in CREW are surveyed pre- and post-CREW to determine the impact of the intervention.

The CREW program is currently being implemented in 6 hospitals, 1 continuing care facility and 2 healthcare administration offices in both Nova Scotia and Ontario.

Describe how your practice was implemented and the resources required (e.g. people, time, money):
The CREW program originated in the Veteran Affairs Administration in the United States, and was adapted by Dr. Michael Leiter into a Canadian version. It is administered by CREW Canada staff from Nova Scotia. CREW Canada staff train on-site facilitators to lead groups within their organization and they provide on-going support for them during the process. Each site/organization identifies a CREW Coordinator from the organization who implements the CREW program at their site, as well as several CREW Facilitators who lead the groups. During the 6 month process, the Coordinator requires approx. 10 hours/month to implement the program (although more hours are required in the beginning). The Facilitators require 8 hours/month to plan and facilitate the groups. The cost of the program is available by contacting CREW Canada at the above email address.

Explain the impact of your practice:
The impact of CREW is determined by the pre- and post-CREW surveys and by anecdotal information gathered on the unit by the facilitators and managers. Survey results reveal that units who participated in the CREW program reported less absenteeism (missed less days of work), less intention to quit, experienced less co-worker and supervisor incivility, and reported more positive mental health outcomes overall. In addition, the feedback from the units that participated in CREW has been very positive and encouraging, indicating that individuals are taking full advantage of the program and its benefits in order to improve their own workplaces.

How did it improve quality of worklife?
The quality of worklife in the units where CREW was implemented has been greatly improved. As mentioned above, survey results revealed that units who participated in the CREW program reported less absenteeism (missed less days of work), less intention to quit, experienced less co-worker and supervisor incivility, and reported more positive mental health outcomes overall. In addition, the feedback from the units that participated in CREW has been very positive and encouraging, indicating that individuals are taking advantage of the program and its benefits in order to improve their own workplaces.

How do you know? (e.g. surveys to staff, a formal evaluation process, specific outcomes, feedback)
Individuals participating in the CREW program (physicians, nurses, clerical employees, allied professionals, etc.) were asked to complete a pre-CREW intervention survey. The survey asked them about a variety of physiological symptoms relating to anxiety and stress, their experiences of civility/incivility at work, and general feelings about their work. After the CREW intervention program (6 months later), surveys were again distributed to measure improvement.

What lessons learned and issues to consider are you able to share with colleagues?
The CREW program works because the agenda and issues worked on by the group are determined by the group themselves. Each group decides what their key teamwork issues are and then problem-solves solutions to these issues. Because groups are the most committed to solutions they come up with themselves, the solutions derived from CREW often become part of the internal workings of the unit. CREW also builds internal capacity because the staff who facilitate the groups actually work within the organization. In these ways, CREW is both relevant and sustainable.