Incorporating ways to establish a team building atmosphere in a work environment can be difficult. Though there are many ways to provide this type of atmosphere to staff, the acceptance of change can arise much resistance. “Regardless of the strategy utilized, the goal is to increase the effectiveness and cohesiveness of either an intact work group or a project team” (Borkowski, 2011 pg 368). With the lack of communication and stress at the general surgery unit, it is evident that working as teams to provide the quality care for patients has been overlooked. With decreasing patient satisfaction and high negativity toward coworkers, Barbara created a way to bring the team together to voice their concerns and try to find solutions to the ever growing problems. The Off Site is a great way to have staff members come together and express their frustration yet they are able to work together as a team to find ways to figure out those frustrations. Having these off site meeting once a month will provide a type of safe haven for those with concerns about their department and as a team find ways to solve them. With this idea of change, there will be immediate resistance. One major resistance will be the fear of the unknown. What will come out of this? How will this affect the way staff members will work with me? “This uncertainty often results in lower morale, increased absenteeism, and reductions in both quality and quantity of output” (Borkowski, 2011 pg 376). As a manager, Barbara should use a transformation that highlights the mission, vision, and values of the organization. By engaging the staff, this transformation will be seen as developments to problem solve their issues at their department. “Changes must be aligned with the organizational mission and strategic direction” (Borkowski, 2011 pg 381). Establishing a work environment in the general surgery unit at EMU, where staff can express concerns and work together will increase morale and the quality of care that is being rendered to patients.