Purpose for the program: Working in a stressful environment can decrease staff satisfaction and also decrease patient safety and satisfaction. The purpose of this program was to improve staff communication between units. The Joint Commission has determined that a breakdown in communication to be one of the leading causes of error. A committee was formed among the Women's Health Units; Women's Health Joint Dynamics (WHJD). It was implemented with the intention of improving unit relationships with communication and collaboration due to unhealthy relationships between the Women’s Health units. The units seemed to be suffering from an "old history" of not being able to get along. The team identifies communication as the main factor in the dissatisfaction and therefore are working on ways to improve communication between team members. The goal of WHJD is to identify and solve professional practice issues by incorporating the use of Evidence Based Practice resulting in enhanced quality of care through improving unit relationships and communication, develop agreeable working relationships and increase patient safety and satisfaction.

 Proposed change:  The desire is to collaborate on a regular basis to address the dynamics of unhealthy relationships between units and work together to improve relationships. The committee will work on projects together with input from staff to increase awareness and opportunities for process improvement ideas from staff; thereby involving staff in the improvement of their own satisfaction.

Implementation, outcomes and evaluation: Presently the committee meets once a month to discuss where there may be a professional issue and how to solve it using Evidence Based practice. The first project the group implemented was bedside report between each other on individual units and also between units when transporting patients to other Women’s Health units. The implementation had a rocky start, but with communication and education it rolled out with positive outcomes. All of the patients were called at home for follow up and asked about bedside report. All of the follow up comments were positive; except for a few due to timing issues. The staff was also asked about bedside report and the majority felt that it helped increase communication and inner relationships. 

Implications for nursing practice:  This collaboration has shown to improve collegial relationships and empower nurses to make decisions that affect their satisfaction in the workplace. With improved staff relationships patient safety and satisfaction will continue to become better and stronger.

Keywords: Building Working Relationships, Unhealthy Work Environment, Improve Communication