I have been traveling and presenting my research on the relationship between communication, collaboration and leadership, and patient and nurse outcomes. During my travels, I have heard numerous stories from staff nurses and leaders who have struggled to make improvements in their work environments. Staff nurses have shared stories of managers who do not support positive changes. Managers have shared stories of administrators who do not support positive changes or environments where they believe union contracts make it difficult to discipline staff for disruptive behavior. Their stories are difficult to hear when clear evidence has demonstrated the benefits of healthy work environments on patient outcomes and nurse retention.1–3  This column provides some guidelines for nurse leaders to develop a “return on investment” case for improving work environments, as well as ideas that others have used to implement the healthy work...

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