EP 57: Collaborative Leadership in Healthcare: Putting People First

CB_57. Dr. Stacy Alves: Audio automatically transcribed by Sonix

CB_57. Dr. Stacy Alves: this mp3 audio file was automatically transcribed by Sonix with the best speech-to-text algorithms. This transcript may contain errors.

Dr. Renee Thompson:
Plants thrive and grow in a peaceful, nourished environment, right? Well, it's the same with human beings. But what if that environment is not so peaceful? What if it's toxic? Welcome to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. In this podcast, you'll get practical, evidence-based strategies to help you cultivate and sustain a healthy and respectful work culture by tackling an age-old problem in healthcare: bullying and incivility. I am your host, Dr. Renee Thompson.

Dr. Renee Thompson:
Hi everyone! Welcome back to another episode of the Coffee Break podcast. Wherever you're listening or watching this, I just hope you're having a really good week, and today's guest is Dr. Stacy, Stacy Alves. And she is the chief nurse executive at Kaiser Permanente in Santa Clara, California. Stacy, welcome to the show.

Dr. Stacy Alves:
Good morning. Great to be here, thanks.

Dr. Renee Thompson:
So Stacy and I go way back. We started doing work together when you were at a different organization. I think you were in the interim, was it a director of education role?

Dr. Stacy Alves:
I was the director of education and the interim director for maternal child health, which I had no clinical experience in.

Dr. Renee Thompson:
Yeah. It's interesting. I actually worked with, she was a manager of a neurosurgical department, and they weren't going to hire her because she did not have any neuro experience. And she said, here's the deal, I'm a good leader, and as long as I have a couple of excellent clinicians who are experts, we're going to be just fine. And she was a great leader and ran a really great department, and I ended up working there for a couple of years, and that's where I got my chops on in that, not neuro. So, yeah. Okay, you were in that role, those roles. And then you moved over to KP Santa Clara, and Stacy, weren't you in an interim role first? And then they made you the permanent CNE, or were you right there CNE from the beginning?

Dr. Stacy Alves:
Yeah. I came here as part of the CNE fellowship in the associate CNE role, and there was a quicker-than-expected transition into the interim CNE role because my predecessor got a promotion. So I got to step up pretty quickly, and then ultimately came to be in this role permanently.

Dr. Renee Thompson:
Wow. Yeah, sometimes, it takes forever, but it sounds like you had a really quick, Here you go, now you're permanent. And just so you all know, those of you who are listening or watching, Stacy and I have been working together. So we've done a lot of work in Santa Clara, and I consider Stacy not only a client but a really good friend and love the fact that I'm on the East Coast and she's on the West Coast, and we will have those like, for me, it's in the evening. She'll text me. Hey, do you have a couple of minutes? I really want your advice, or let's talk about something. And I've just grown to love the conversations that you and I, Stacy, have had. Because just because you're a CNE, you're in an executive role, it doesn't mean you don't need to bounce some things off of someone or to get some help.

Dr. Stacy Alves:
Absolutely. I always say it takes a village to be a good leader, and you are one of the key members of my village.

Dr. Renee Thompson:
Thank you. You're one of the key members of my village, too. So I love it. Just to let you know a little bit more about Stacy. She has her doctorate in executive leadership. She is a certified improvement advisor and a Heart Math instructor, which before I continue, what is that? Can you tell us what that means? … Petition, which I don't think so, but.

Dr. Stacy Alves:
No, it's called Heart Math. It has to do, so the Heart Math Institute has done a lot of research and work with huge major organizations. Really, what it comes down to is harnessing the power of the physiological heart-brain connection to regulate emotions, neurotransmitters, and be your most coherent self.

Dr. Renee Thompson:
Wow, that, I love that. It's like the whole left brain/right brain concept that we use that a lot. With the work that we do, you've got the left brain people show me the evidence. But yet, you've got the right brain people who are like, tell me the story, how this applies in my life. And it sounds very similar, so I'll have to look into that. I remember hearing about it before, but I've never done a deeper dive, so maybe that'll be one of our evening conversations. Tell me more.

Dr. Stacy Alves:
There you go.

Dr. Renee Thompson:
Yeah, the other thing that I really love about you, Stacy, is your leadership philosophy. And it's pretty simple when you think about it, but I'm going to ask you to unpack it a little bit. You say, if we take really great care of our people, then they will take great care of your patients. And it's so simple, but yet, why is it sometimes so hard for organizations to understand that? And then I think it's how do you actually make that happen in like practice so practical application. So I really want to start having a conversation about that. I can only imagine as a CNE, you are bound to these like metrics and outcomes and problems because people don't just say, hey Stacy, do you have a couple of minutes? I have this wonderful news or these wonderful success stories to share with you. They're usually contacting you because they got a problem. They've got an issue. So like, why is people in your culture such a primary focus of yours?

Dr. Stacy Alves:
Yeah, absolutely. We have, on any given day, 300 or 400 patients in these walls. And there's no way that I can personally impact each and every one of them. As the CNE, I'm accountable for metrics across every pillar of the organization who's really doing the work that drives those outcomes. It's the people. It's the nurses, the technicians, the physicians that are out there delivering the care, taking care of the equipment. So if they're, don't have the tools they need or they're working in a culture that is acidic and toxic, they can't be their best selves, they can't do their best work, and that's going to show up in those metrics. So I've really taken a philosophy of: take good care of the people, set them up for success to take great care of the patients, and the numbers will follow.

Dr. Renee Thompson:
Okay, so can you give us maybe a practical example, because I can only imagine day in and day out? You're dealing with a lot of problems, issues. You've got to hit your numbers, and you're looking at staffing ratios and all of that. How does it show up, though, that you put your people first? Like how how do you can you give us a practical example?

Dr. Stacy Alves:
Yeah. So, actually, yesterday, we celebrated this really great performance improvement project around 80 throughput across the nation. Everyone's focused on throughput, access to care. Patients are spending too long in the ED, etc. And so our approach to this, we brought the multidisciplinary team together. We did some of the homework for them in terms of mining the systems, and we really brought them in the room and said, what are the pebbles in your shoe? What is getting in the way of you doing what you need to do? Very systematic, very disciplined approach, but bringing them together, giving them the space and the time and the power to say, this is what we need to take off. This is what we need to do different. This is how we can streamline. They had such joy and meaning in the project, and we did a pre and post for employee satisfaction, and our ED border times have reduced. We set a goal of 5% reduction. Blew that out of the water. Our seamlessness of the throughput, our patient satisfaction as it relates to the RN and MD giving consistent information, month over month, has grown since we started this project. So phenomenal care experience, patient satisfaction, access results and our people love the process, so it's going to be more sustainable.

Dr. Renee Thompson:
Wow. Okay. I wrote down a few things here. First of all, I love that whole, what's the pebble in your shoe? Okay. What's that little thing that drives you nuts? And there's an activity that we do. And it's funny, I'm working on, I'm doing a retreat for a client, actually, at the beginning of October, and it's. I think this episode doesn't air until the end of October, so I would have done this already. But we're doing an activity called The One Thing, and I've done this before with my clients is you ask everybody, what's one thing? If we fix this one thing, it would make everything else easier. And then you have people, you do sticky notes, and you put them on a board, and then you collate them. And then that one thing, you look at them all, and you say, okay, do we have any control over this? Yes or no? Do we have any control over this? Yes or no? And then you really focus on those things that you have some control over and you pick one and start working on it. But this is brilliant, and it's so simple that it's, I don't know if I should say it's shocking or not, that organizations don't always think this way. You're talking about gathering a multidisciplinary group together, and what you're doing, Stacy, it's collaborative problem-solving. You're not coming in saying, hey, we have this 10-page or 100-page strategic plan on how you're going to improve throughput. You're like, okay, here's the problem. We got to work on this. Get the people who are there, yes, together. Because what you're doing then is you're empowering them to be part of the solution. It's that, again, that whole collaborative problem-solving. Now, how do you determine who gets involved?

Dr. Stacy Alves:
It's a combination of looking at who's impacted by the work, who's doing the work, and then picking people who are your early adopters so that they're on board with change ideas. They have the social capital within their teams to influence change, and they're willing to put in the work. And when it gets hard, they're going to stick with it as long as you set them up for success.

Dr. Renee Thompson:
Okay. So I'm going to ask you this because I think you're doing this really well, and some of the work that we've been doing together is part of that. There's always going to be resistors.

Dr. Stacy Alves:
Oh, yeah.

Dr. Renee Thompson:
And when it comes to something like, oh my God, throughput making it, getting patients in and out quicker and to the next level of care and all those things. And you said early adopters, but sometimes it's like you have to dip back into the same well over and over again because some of these people get burned out after a while because they are the ones who are. They want to see improvements; they want to be part of the solution. How do you handle those resistors who either, they don't want to get involved, even if you ask them, or they resist the change? Especially you're like, okay, throughput. We came up with this plan, and they resist. Do you have any strategies for that?

Dr. Stacy Alves:
Yeah, you know, I tell my teams, I don't even remember where I heard this, but I absolutely love this saying, water the flowers, not the weeds. Oh, as leaders, we want to put all our energy and our focus on the people who are doing what, doing the behaviors that we want to see engaging, whether it's the actual process itself or how promoting the change. Public recognition in huddle. Hey, I see that you used the new phrase, and we're so glad. Thank you. And so putting a lot of spotlight on that and then minimal effort performance management on the other. So that's a one-on-one conversation. Hey, I see you didn't. And the impact to the patient is, and the expectation remains. Can I count on you to do this moving forward?

Dr. Renee Thompson:
Oh, okay. Say that again. Can I count on you say that again? That was great. Yeah.

Dr. Stacy Alves:
Can I count on you to do this moving forward? And I'll often put in because it's really important to the team or it's really important to the patients.

Dr. Renee Thompson:
And so, adding that impact is key, even if you're talking about, and I would say, and Stacy, I know you would agree with me, adding the impact, whether it's a positive behavior, a behavior you want to see continue or a negative behavior that you want to see stopped, so everybody gets involved. And this is where I think we miss the opportunity as leaders, especially executive leaders. Okay, so you have this group of individuals who are committed. They're invested, they're engaged, they want to make it better, and they do. It's circling back and saying, because you were involved, because you were a part of this, look what we've been able to do. And I think this is where you can use that whole heart and brain, left brain, right brain. Look at the improvements in our throughput data. And if that think about that patient who came in, who's someone's mother. I always pull the mom card. Now that patient got to where they needed to go quicker. It wasn't like, could you imagine? Like a colleague of mine, her husband has sciatica issue a herniated disc and oh my God is in pain all the time. Could you imagine putting that patient on a stretcher in the emergency department and making them lay there for hours and hours? So it's circling back on them to say, because you were involved, these are the results to, you know, if you're not going to get involved or one of the resistors, like I said, I love that whole water, the flowers, not the weeds, but letting them know the impact that their engagement, their resistance has on the work, their team and the patients. And ultimately, do you ever think sometimes, like, why do we have to remind people that we chose to work in healthcare? Okay, everything that we do should be about the patient and making the patient's experience better so that they have a better outcome. But sometimes, I think people have it backwards. Like, how do I make this easy for me? What's best for me? And I'm like, oh, you certainly don't want to say no. You have to suffer. Okay. If you choose to work in healthcare, you know, we have to make you suffer, but we do. It is a service industry. And I know you've done a really good job. We've heard it all. Put your own mask oxygen mask on first. But how do you then, as an executive leader, really be that role model for a healthy work culture by truly showing them that you're taking care of yourself, too?

Dr. Stacy Alves:
Yeah. So I really integrate role modeling into my leader standard work. I literally have a leader standard work document, and I have on there a daily checklist for resilience practice. So I have a walking pad in my office. So if I have a meeting where I'm not presenting, I'm not needing to type a lot. I'll put out my walking pad. Now, it's slow; it's safe for all the workplace safety people out there, but I'm getting my steps in, and I find myself more focused and more engaged. And then, recognition, right? So when somebody calls out sick, I respond, thank you for putting your health first. I hope you feel better soon. So I look for those little opportunities when somebody speaks up, and they have a question; it's not challenging, but they want to know, hey, what about? Or they have an idea. I thank them for bringing that forward. So, I really try and be intentional about how my behaviors support a culture of health and a culture of well-being.

Dr. Renee Thompson:
Because sometimes we're not really good role models, are we? We'll take care of yourselves, and then we're answering email at 10:00 at night, on the weekends, on holidays.

Dr. Stacy Alves:
Yes. And I, to be fair, I actually got called out on it. I was sharing our PayPal polls with the frontline team, and one of the nurses said, how are you, as our senior leader, role modeling health? And the good news, I wasn't on camera because my jaw hit the floor because, at first, I was like, How am I? And I could think of a couple things, but that was really my call to action for, how will I be more intentional to do that?

Dr. Renee Thompson:
As part of this, I do this one retreat. It's called 8 Essential Skills of a Healthy Interprofessional Team. And there are eight skills. And we first focus on the leader. How do you develop that skill in yourself as a leader, and then how do you develop that skill in your team? And feedback is one of those skills. And we do this hot seat activity and it's one of my favorite things to do. You ask for volunteer. You put one person in a hot seat and you can even do this like, I've done this at a conference where I tell people to make up stuff. Okay, so it's tell me one thing good about this person, one thing that they do, one reason you like working with them. It's got to be something positive and people, it's easy for them to do. And then I say, what's one thing this person could do better? And I did this. It was in an organization, so they weren't making it up. Everybody knew this person, and someone said, when you're on vacation, please be on vacation. Please don't answer emails because the unintended consequence of that was this, the team, who reported this leader then started to think that this leader didn't trust them to handle situations without her, and it was a moment. Like, talk about I wish we had a camera, because the look on her face was this huge light bulb awareness. Like I thought I was helping because I felt that I was on vacation. Like, no, you would help us if you would just go on vacation and let us handle things. And I thought because she was not role-modeling healthy behaviors, and sometimes we need to be called out on it.

Dr. Stacy Alves:
Yeah. Not only does it show trust to your team, but it also shows your team. It's okay to take a break. Because if I'm emailing late at night, it doesn't matter if my signature line says my work life is different than your work life. If I'm emailing at 8:00, then my new direct report is seeing that and thinking, oh, that must be what she expects.

Dr. Renee Thompson:
Oh, yeah.

Dr. Stacy Alves:
No. So sometimes, I do need to carve out late-night time. My brain's going, kids are in bed, but I'll use, there's this Outlook feature that says schedule send, so I'll send it to go out at 8 a.m. the next morning. So, at least, I may have needed to carve out that time for my own sanity. But I'm not sending the message to my team that I expect them to do that.

Dr. Renee Thompson:
This actually happened, it was in the exact same situation. There was someone on my team who, on the weekends, because I would always tell my team, look, I work every day, and I'm going to send emails whenever I send, you don't have to reply to them. And then I remember this weekend, this one weekend, I was sending emails, and somebody on my team was answering them, and I said, hey, you don't have to respond. And they said, I hear the ding, and if I'm not doing anything, I respond. And then I thought to myself, what is wrong with me? It's almost like I'm bragging. I work every day, and on the emails, I'm like, shame on me. So I do the same thing. If I'm going to work on Saturday, it's because it's my choice and it might be something. I've had a busy week traveling, so I'll carve out time Saturday, if it's to my team, and a lot of times, to my clients, too. I will schedule that to go out Monday morning or some Tuesday mornings because I know Mondays, people get bombarded with emails, so I'll wait and schedule it on Tuesdays. Although my team makes fun of me, they'll say, yep, we know Renee was working this weekend because they get 57 emails Monday morning. They're like, busted. And Stacy, it is something to be mindful of. Sometimes, we have good intentions, but we don't realize we were talking about impact earlier. We don't realize the impact of our actions, okay, especially when it comes to being that role model for our team. But I have to go back to something because this is intriguing to me. I want to learn more about your leader standard work. So, is that like your list of rules? Is it a checklist that I really want to learn more of this? Because all of a sudden, I'm like, oh, I want to have leader standard work too.

Dr. Stacy Alves:
Yeah. So, it is a checklist, but it's more focused on leader behaviors. So it's tools for me to be more intentional about my behaviors and how I'm setting my team up for success. So it's a big actually. I have it here. It's a big document, right? And it breaks down daily, weekly, and monthly. And so I have on my daily I have recognized someone, I have nurse leader rounding, I have personal wellness habits, and I have reviewed data of the day, so that helps me keep up to date and make sure that I'm being intentional in the middle of all the other things that are coming unexpectedly throughout the day. And then it also helps me, there's things that are on here that are quarterly that if I don't have a trigger, I might forget. And that was really important and I needed to plan ahead for it.

Dr. Renee Thompson:
So how many, just, I really want to get practical here. How many daily things do you have on your list? Because I know a lot of us, we think we can get a lot more done than we actually can. What are, how many daily activities?

Dr. Stacy Alves:
So it's an evolving it's a living document. When I started there were probably 12 or 13. Right now, there's five.

Dr. Renee Thompson:
Smart.

Dr. Stacy Alves:
Oh my God, I've had to get there was so much red ink. I had to get honest with myself about what can I really prioritize daily. And by having the daily visual mark of, I give either myself a green star or a red little x mark. And so I can see very quickly how well am I doing what I said I would do.

Dr. Renee Thompson:
And this is something written, right?

Dr. Stacy Alves:
Yes.

Dr. Renee Thompson:
The document. But is it something then, that you cross off as you go along?

Dr. Stacy Alves:
Yeah, it has little boxes so I can check either each day or each week, yeah. And I keep it right in front of my face, because if it gets buried by even one piece of paper, then it's not in the front of my brain.

Dr. Renee Thompson:
So then, do you get that little dopamine hit every time you cross something off?

Dr. Stacy Alves:
Absolutely. I love my dopamine.

Dr. Renee Thompson:
Me too. Like, it was so funny. So, as a company, we have quarterly rocks. So, my husband and I just came up with our quarterly rocks for Q4, and one of them is our foundational course, are Eradicating Bullying and Incivility course. We're completely revising it. It's not going to be the Zoom PowerPoint slide deck. It's all going to be new. Okay. We're really excited about it. We have a really great video editor who's going to help us with everything. So that's an example of one of our big rocks, and it's going to take us three months to do it. We have usually 5 or 6 of them. With my team, this is what they did. I said, okay, we have big rocks. Somebody then added, and actually, it may have been me at first. Okay, now that I think of it added, okay, we have five big rocks. Here are five little rocks. Someone else, though, added pebbles, and then someone added sand. I'm like, no, we cannot.

Dr. Stacy Alves:
Yeah, the sand is not planned.

Dr. Renee Thompson:
We cannot have all of that because that's just an enormous to-do list. And but at the end of every quarter, if you put so think about it, at the end of every quarter, at the end of every month, every week, every day, if your to-do list is unrealistic, you're going to feel that you haven't accomplished anything. But I love the fact that you started at 12, and you really narrowed it down to what are the five behaviors as a leader that I need to every single day implement. So I think that's so smart, so smart. Okay, as we start wrapping up, what would you say if somebody's listening or watching, what's one piece of practical advice you would give to. Let's talk about our brand new leaders who wanted to get started to really show up as a leader who cares about her people and takes care of her people so that her people can take care of those patients.

Dr. Stacy Alves:
Can't care about your people from your desk. It is so easy to become a slave to your calendar, to the meetings, etc., and I've had to get really good and really disciplined at what I say no to. I have a post-it note on my monitor that I see every morning. It says where am I needed most right now? So I will leave a meeting to go round and get FaceTime, and I will look at, I haven't been to this department in a while, and make sure your presence is your currency as a leader, and you have to keep depositing.

Dr. Renee Thompson:
I think that should be a bumper sticker. Okay, you can't care about your people from your desk. And when I was a unit director, brand new, a lot of people know my story, I only lasted a year. I had no idea what I was doing, and there were so many bad behaviors that I was just ill-equipped. And it's one of the reasons that I do this work now is because I felt like such a failure, and I wasn't a failure, I just wasn't equipped. Stacy, I sat at my desk every day, and I wasn't with my people because I didn't know how important that was. And now, when I look back, when I think about the potential that I had to really transform that department, I wasn't ready for it yet. Again, but just that concept, that philosophy right there, you cannot lead your people, care about your people from your desk. You have to be where your people are. And how do you then, I don't know, balance that? Because this was always my excuse. I have so many emails I have to answer. I have so many things that I have to do and payroll and this or that. So I felt trapped to be in my office. How do you get past that?

Dr. Stacy Alves:
Yeah, one, I say this half-jokingly, but also very much from a place of support when I have new managers or directors. And I've learned not to say this in the very beginning: I let the fire hose die down, but essentially, it's welcome to 24-hour leadership. You're never going to feel done again, and that's okay. As leaders, we have to embrace discomfort and learn how to get more comfortable with it, whether it's an uncomfortable conversation, whether it's setting boundaries, or whether it's being okay. I'm at a good enough stopping point right now to step away from this, and I will pick it back up later because we have 24/7 accountability, but that doesn't mean 24/7 work.

Dr. Renee Thompson:
Because you'll never get everything done, and I think those of us who have been in leadership roles for a long time, we recognize that and really great advice and listening to it myself. Okay, I'm just going to sit here, and I'm going to spend 2 or 3 hours answering all my emails and trying to get everything. Guess what? The next day, I've got another hundred emails. You'll just never get it all done. But it's the prioritizing. And yes, really want to develop a healthy work culture? You got to prioritize being with your people.

Dr. Stacy Alves:
Yeah, and learn the technology hacks. So my favorite new one we have Copilot now, and I can go to Copilot and say, catch me up on my email, summarize and organize by topic, and it will literally just, here's all the main points in my inbox. So and so said this, so and so said an invitation about this. And then, from there, I can dig deeper. So, at the end of the day, I can do that. And I know I'm not missing any of the really big stuff.

Dr. Renee Thompson:
So we've started using GPT, okay? This is how I use it. And I just did this. I put together this outline. It was for our course and a timeline, but I wanted an introduction paragraph, so I would ask GPT, write me an introduction paragraph for this and explain what it was. And it was like, oh, beautiful. Yes, and it took all of 10 seconds, okay. And it would have taken me probably 15, 20 minutes. We use it a lot for that repurposing content, but we don't use it. We use it as pure generative. I had no idea that you could say prioritize my email. Give me the key. I don't know, you could do that.

Dr. Stacy Alves:
Yeah. As soon as we got the Copilot license for Microsoft, I started like googling basically, what are my life hacks with this? Like, how can this make my job easier?

Dr. Renee Thompson:
Oh my gosh, all right, I'm writing that down. Life hacks, because I'm always looking too for those shortcuts. Even something as simple as okay, my email address is long. Okay, [email protected]. So yeah, just a little, I have keypad code. I just do zzz, and my email address pops up. I mean, just something simple like that. So I'm also always looking for life hacks just to cut down on time that it takes to do some simple things. But oh, see, I don't know. I actually thought about Copilot, but we use Microsoft. But I'm wondering if there's other like what we're using. If we could, I'm gonna have to ask GPT for the life hack. So I think that's great advice. Make technology work for you.

Dr. Stacy Alves:
Exactly, yeah.

Dr. Renee Thompson:
That you can be with your people.

Dr. Stacy Alves:
There you go.

Dr. Renee Thompson:
Bottom line. Okay. Stacy, if somebody wants to connect with you, what's the best way?

Dr. Stacy Alves:
I'm on LinkedIn, Stacy Alves. Stacy, there's no e, is really the best way to find me.

Dr. Renee Thompson:
Okay. So, we will make sure we have Stacy's LinkedIn profile in the show notes. This has been such a great conversation. Like I said, I loved our chit-chats in the evening, and it's nice to actually hop on this platform and just chat about the wonderful work that you're doing as a leader at KP Santa Clara. And I'm a huge fan of you and your other leaders and the people there. I've been doing work with you all for, I think, at least 5 or 6 years now, and have just really seen the impact, the positive impact that you can have when you have leaders who care about their people so that their people can care for their patients. So Stacy, thank you for being a guest on my show.

Dr. Stacy Alves:
Thank you. Always great to get to chat with you.

Dr. Renee Thompson:
I know! And for those of you who are listening or watching, we know you're busy. Thank you for being here. Being a leader is not easy. We're hoping that what you're learning in this podcast makes it a little easier for you, because you have important work to do. And if you like this podcast, if you can, please post a review. You can rate us. We're actually in a campaign right now to try to get 50 reviews by the end of the year. And so, if there's anything that you can do to help us out, that would be great. And if a leader who might want to hear this episode. If you can, please share it with them. So thanks for everything that you do. Take care. We'll see you next time.

Dr. Stacy Alves:
Thanks!

Dr. Renee Thompson:
Thank you for listening to Coffee Break: Breaking the Cycle of Bullying in Healthcare – One Cup at a Time. If you found this podcast helpful, we invite you to click the Subscribe button and tune in every week. For more information about our show and how we work with healthcare organizations to cultivate and sustain a healthy work culture free from bullying and incivility, visit us at HealthyWorkforceInstitute.com. Until our next cup of coffee, be kind, take care, and stay connected.

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