Civility, Respect, and Engagement in the Workplace (CREW)
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What is CREW?
Civility, Respect, and Engagement in the Workplace (CREW) is a VA-wide culture change initiative. First launched in 2005 by the VHA National Center for Organization Development (NCOD) in response to employee feedback that low levels of civility affected their level of job satisfaction, it has since been utilized by over 1,200 VA workgroups to establish a culture of respect and civility in their organization.
Civility is an essential behavior of all employees in all organizations. These are the interpersonal “rules of engagement” for how we relate to each other, our customers, and our stakeholders; the fundamentals of courtesy, politeness, and consideration.
Respect connects us at a personal level. It reflects an attitude developed from deep listening and understanding, cultural and personal sensitivity, and compassion. It honors all the participants in an interaction by creating a safe place to have difficult conversations and leads to an environment of honesty and mutual trust.
Engagement is the result of respectful relationships within an atmosphere of trust. It provides all staff with the charge, the parameters, the training and the support to make decisions “on the spot” in the best interest of the veteran.
The goal of CREW is to improve the work climate through more civil and respectful interactions. Trained facilitators meet regularly with identified groups for approximately six months with the intent to give the group the necessary time to focus on creating a respectful and civil work environment. Facilitators come to the meetings prepared to facilitate discussions, encourage problem-solving efforts, and conduct exercises and activities that can help improve how the group participants relate to one another. The regular meetings provide a forum for discussions of how to improve the work environment as well as provide a place to practice new behaviors and ways of interacting so these can become the norm. CREW is not magic; the changes will not happen over night. The facility leadership, the workgroup’s manager, as well as the group members themselves, must be committed to and willing to engage in the process.
Does CREW look the same at each site?
There is no manual for CREW so the content of CREW meetings may look very different at each site. However, the initiative is structured similarly in that each facility will identify a CREW coordinator to organize the initiative, CREW facilitators to run CREW meetings, and workgroups to participate in the meetings. Careful selection of these roles is important to the success of CREW, and NCOD is happy to provide you with guidance related to this selection process.
What are the benefits of CREW?
CREW research has found that civility impacts a variety of factors that are of importance to administrators, clinicians, and non-clinical staff, including higher overall job satisfaction, increased intent to stay in the current position, reduced sick leave usage, fewer EEO complaints, and better patient care outcomes. Please refer to the CREW Business Case handout for more detailed information about these outcomes.
“The link between employee satisfaction, patient satisfaction and clinical outcomes is clear. CREW has provided the necessary tools for us to achieve unprecedented levels of civility, respect and engagement in the workplace, resulting in patient satisfaction.”
- Rica Lewis-Payton, Birmingham Medical Center Director
“Through CREW, employees were able to identify and change unappreciated behaviors in the workplace. Employees work together where they resisted before, and are cordial where they avoided one another before. Sincere commitment to CREW will make a difference where you work."
- Cliff Wrencher, CREW Facilitator, AFGE President at CAVHCS
“My CREW experience as a facilitator has been fantastic. Employees engaged in open and honest dialogue, renewing lines of communication and gaining awareness of behaviors. They were able to see others’ points of view and resolve some of their own issues.”
- Bettie Bookhart, CREW Facilitator, St. Petersburg VBA Regional Office
“The routine reinforcement and progression used in CREW ensures sustained improvements. Every medical center should consider having CREW in place for both teams that need help and for already high-functioning teams.”
- Tom Mattice, Indianapolis Medical Center Director
“CREW gave us a better understanding of ourselves and our coworkers. CREW was able to lay the groundwork for building that relationship that enabled us to provide the highest level of patient care. I would recommend CREW in any workplace.”
- Michael Clayton, RN in Case Management, Birmingham VA Medical Center
“Everyone wants to do a good job! CREW helped everyone realize that all services have obstacles to face. Acknowledging these obstacles and working WITH each other to face challenges helps everyone feel better and ultimately helps the patient.”
- Irene Watson, RNP, Hospitalist, Providence VA Medical Center
“I was admittedly skeptical going in but we saw outstanding results. It taught us that each of us communicates differently and that many of our disagreements were actually due to lack of communication rather than actual issues.”
- Kyle Inhofe, Chief of Human Resources, Oklahoma City VA Medical Center
“It was a good way to get to know your fellow employees, build team work and communication.”
- Jeanette Rowland, Prosthetics Representative, Dayton VA Medical Center
“CREW has assisted the QM staff to learn about each other. By taking time to really know each other, conflict is decreasing and understanding is increasing.”
- Margaret A. Russell, Chief of Quality Management, Saginaw VA Medical Center
How do I start CREW at my VA site?
If you are interested in the CREW initiative, please call or email Dr. Kasey Kruer at 513-247-4680. Dr. Kruer will send you relevant CREW documents, and ask that the site leadership select someone to coordinate the CREW initiative at your facility. She will also ask to schedule a call that will include her, the facility director (and possibly other members of the executive leadership team), your facility's labor partners and the CREW coordinator to talk about the program and answer any questions. The Medical Center Director and the labor partners will be asked to sign a document outlining the requirements for participation in the CREW program. The CREW coordinator will then continue regular contact with NCOD to prepare for the kick-off of CREW in your facility. These preparations will include choosing CREW facilitators, sending the CREW coordinator and facilitators to an initial training meeting, and choosing a workgroup to participate in CREW.
How do I learn more about the CREW Initiative?
For more information about CREW, please contact Dr. Kasey Kruer at the National Center for Organization Development (513-247-4680).