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Cleveland Clinic’s Imaging Institute implemented a “Commitment to Respect” initiative and survey process in March 2013 with the goal of improving communication and teamwork among employees and, in turn, improving patient satisfaction. Since the rollout of this initiative, we have worked to increase acceptance of the process, improve the survey response, and more fully incorporate results into staff development. Now that we have 4 years of annual data for analysis, we can state based on feedback from caregivers that the process has had a positive effect on relationships between radiologists and frontline clinical staff. The survey identifies behaviors that individuals were not previously aware of, allowing staff members to make changes based on this feedback. Additionally, institute leaders are able to reinforce the respectful behaviors of those scoring well and support the efforts of those whose scores need improvement. Both scenarios are reinforced through the radiologist annual performance review process.