Assignment:The Highest Nursing Leader

Review Appendix A, Sections I–V in Finkelman (2012, pp.510–515). 1.Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies.Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board. 2.In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader.What one is more like your Nurse Executive? 3.Describe how the Nurse Executive “leads the charge” fortransformational leadership in an organization where you work orhave done prelicensure clinical experiences. reading: A Nurse Executive Competencies I. and Relationship-Building a. Effective Make oral presentations to diverse audiences on nursing, healthcare, and organizational issues Produce cogent and persuasive written materials to addressnursing, health care, and organizational issues appropriate to theaudience Resolve and manage conflict b. Relationship Management Build trusting, collaborative relationships with    -Staff    -Peers    – Other disciplines and ancillary services    -Physicians    -Vendors    -Community leaders    – Legislators    -Nursing and other educational programs Deliver “bad news” in such a way as to maintain credibility Follow through on promises and concerns Provide service recovery to dissatisfied customers Care about people as individuals and demonstrate empathy andconcern while ensuring that organizational goals and objectives aremet Accomplish objectives through persuasion, celebrate successesand accomplishments, and communicate a shared vision Assert views in non-threatening, non-judgmental ways c. Influencing Behaviors Create and communicate a shared vision Reward appropriate behaviors and confront and manageinappropriate behaviors Develop, communicate and monitor behavior expectations d.

Assignment:The Highest Nursing Leader

Assignment:The Highest Nursing Leader

Diversity Create an environment which recognizes and values differences instaff, physicians, patients, and communities Assess current environment and establish indicators of progresstoward cultural competency Define diversity in terms of gender, race, religion, ethnicity,sexual orientation, age, etc. Analyze population data to identify cultural clusters Define cultural competency and permeate principles throughoutthe organization Confront inappropriate behaviors and attitudes toward diversegroup Develop processes to incorporate cultural beliefs into care e. Shared Decision Making Engage staff and others in decision making Promote decisions that are patient-centered Provide an environment conducive to opinion sharing f. Community Involvement Represent the organization to non–health care constituentswithin the community Provide consultation to community and business leaders regardingnursing and health care Be an effective board member for community and/or professionalorganizations g. Medical Staff Relationships Build credibility with physicians as a champion for patientcare, quality, and nursing professionalism Confront and address inappropriate behavior towards patients andstaff Represent nursing at medical executive committee and othermedical staff committees Collaborate with medical staff leaders in determining neededpatient care services Collaborate with physicians to develop patient care protocols,policies, and procedures Collaborate with physicians to determine patient care equipmentand facility needs Utilize medical staff mechanisms to address physician clinicalperformance issues Facilitate disputes involving physicians and nurses or otherdisciplines h. Academic Relationships Determine current and future supply and demand for nursing careIdentify educational needs of existing and potential nursingstaff Collaborate with nursing programs to provide requiredresources Collaborate with nursing programs in evaluating quality ofgraduating clinicians and develop mechanisms to enhance thisquality Serve on academic advisory councils Collaborate with nursing faculty in nursing research andincorporate nursing research into practice II. Knowledge of the Health Care Environment

Assignment:The Highest Nursing Leader

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a. Clinical Practice Knowledge Maintain knowledge of current nursing practice and the roles andfunctions of patient care team members Articulate patient care standards as published by JCAHO [JointCommission], CMS, and professional nursing literature Understand, articulate, and ensure compliance with the StateNurse Practice Act, State Board of Nursing regulations, regulatoryagency standards, and policies of the organization Ensure that written organization clinical policies andprocedures are reviewed and updated in accordance withevidence-based practice Role model lifelong learning, including clinical subjects suchas disease processes, pharmaceuticals, and clinical technology b. Delivery Models/Work Design Maintain current knowledge of patient care delivery systems andinnovations Articulate various delivery systems and patient care models andthe advantages/disadvantages of each Serve as change agent when patient care work/workflow isredesigned Determine when new delivery models are appropriate, and thenenvision and develop them c. Health Care Economics Articulate federal and state payment systems and regulations, aswell as private insurance issues, which affect organization’sfinances Understand and articulate individual organization’s payer mix,CMI, and benchmark database d. Health Care Policy Articulate federal and state laws and regulations that affectthe provision of patient care, e.g., tort reform,malpractice/negligence, reimbursement Participate in the legislative process concerning health carethrough membership in professional organization and personalcontact with public officials Educate patient care team members on the legislative andregulatory processes and methods for influencing both Interpret impact of state and federal legislation on nursing andhealth care organizations e. Governance Articulate the role of the governing body of the organization inthe following areas: Fiduciary responsibilities Credentialing Performance management Represent patient care issues to the governing body Participate in strategic planning and quality initiatives withthe governing body Interact with and educate the organization’s board membersregarding health care and the value of nursing care Represent nursing at the organization’s board meetings f. Evidence-Based Practice/Outcome Measurement Interpret information from research Utilize research findings for the establishment of standards,practices, and patient care models in the organization Disseminate research findings to patient care team members Participate in studies that provide outcome measurements Allocate nursing resources based on measurement of patientacuity/care needed g. Patient Safety Support the development and implementation of anorganization-wide patient safety program Design safe clinical systems, processes, policies, andprocedures Monitor clinical activities to identify both expected andunexpected risks Support a non-punitive reporting environment and a reward systemfor reporting unsafe practices Support safety surveys, responding and acting on safetyrecommendations Ensure staff is clinically competent and trained on their rolein patient safety Articulate and take action to support the JCAHO National PatientSafety Goals h. Utilization/Case Management Articulate organization for the criteria model adopted by theorganization Communicate key points of the model to a variety of audiences(nursing, financial, medical staff) Involve physicians in on-going utilization managementpractices Design continuum of care options for managing patient throughput(long term care units, urgent care centers, admission/dischargeunits, etc.) i. Quality Improvement/Metrics Articulate the organization’s QI program and goals Determine patient care quality improvement goals andobjectives Define metrics as related to process improvement Explain and utilize metrics as a unit of measure for anyprocess Articulate the link between metrics and goals Articulate the link between organization metrics and nationalquality initiatives/metrics Target outcomes that are evidence-based (comparison databenchmarking) Define quality metrics by Identifying the problem/process Measuring success at improving specific areas of patientcare Analyzing the root causes or variation from qualitystandards Improving the process with the evidence Controlling solutions and sustaining success j. Risk Management Identify areas of risk/liability Ensure staff is educated on risk management and complianceissues Develop systems which encourage/require prompt reporting ofpotential liability by staff at all levels Envision and take action to correct identified areas ofpotential liability III. Leadership a. Foundational Thinking Skills Address ideas, beliefs, or viewpoints that should be givenserious consideration Recognize one’s own method of decision making and the role ofbeliefs, values, and inferences Critically analyze organizational issues after a review of theevidence Maintain curiosity and an eagerness to explore new knowledge andideas Promote nursing leadership as both a science and an art Demonstrate reflective leadership and an understanding that allleadership begins from within Provide visionary thinking on issues that impact the health careorganization b. Personal Journey Disciplines Value and act on feedback that is provided about one’s ownstrengths and weaknesses Demonstrate the value of lifelong learning through one’s ownexample Learn from setbacks and failures as well as successes Assess one’s personal, professional, and career goals andundertake career planning Seek mentorship from respected colleagues c. Systems Thinking Promote systems thinking as a value in the nursingorganization Consider the impact of nursing decisions on the health careorganization as a whole Provide leadership in building loyalty and commitment throughoutthe organization Synthesize and integrate divergent viewpoints for the good ofthe organization d. Succession Planning Promote nursing management as a desirable specialty Conduct periodic organizational assessments to identifysuccession planning issues and establish action plans Serve as a professional role model and mentor to future nursingleaders Establish mechanisms that provide for early identification andmentoring of staff with leadership potential Develop a succession plan for one’s own position e. Change Management Utilize change theory to plan for the implementation oforganizational changes Serve as a change agent, assisting others in understanding theimportance, necessity, impact, and process of change Support staff during times of difficult transitions Recognize one’s own reaction to change and strive to remain opento new ideas and approaches Adapt leadership style to situational needs IV. Professionalism Personal and Professional Accountability Create an environment that facilitates the team to initiateactions that produce results Hold self and others accountable for actions and outcomes Create an environment in which others are setting expectationsand holding each other accountable Answer for the results of one’s own behaviors and actions Career Planning Develop own career plan and measure progress according to thatplan Coach others in developing their own career plans Create an environment in which professional and personal growthis an expectation Ethics Articulate the application of ethical principles tooperations Integrate high ethical standards and core values into everydaywork activities Create an environment that has a reputation for high ethicalstandards Evidence-Based Clinical and Management Practice Advocate use of documented best practices Teach and mentor others to routinely utilize evidence based dataand research Advocacy Role model the perspective that patient care is the core of theorganization’s work Assure that the clinical perspective is included inorganizational decisions Ensure that nurses are actively involved in decisions thataffect their practice Active Membership in Professional Organizations Participate in at least one professional organization Support and encourage others to participate in a professionalorganization V. Business Skills Financial Management Articulate business models for health care organizations andfundamental concepts of economics Describe general accounting principles and define basicaccounting terms Analyze financial statements Manage financial resources by developing business plans Establish procedures to assure accurate charging mechanisms Educate patient care team members on financial implications ofpatient care decisions Human Resource Management Participate in workforce planning and employment decisions Champion a diverse workforce Use corrective discipline to mitigate workplace behaviorproblems Interpret and evaluate employee satisfaction/quality of worksurveys Create opportunities for employees to be involved indecision-making Reward and recognize exemplary performance Formulate programs to enhance work-life balance Interpret legaland regulatory guidelines Manage collective bargaining environments or implement programsto avoid the need [sic] Identify and eliminate sexual harassment, workplace violence,and verbal and physical abuse Implement ergonomically sound work environments to preventworker injury and fatigue Develop and implement bioterrorism, biohazard, and disasterreadiness plans Identify clinical and leadership skills necessaryfor performing job-related tasks Select top talent, matching organizational needs withappropriate skill sets (assess job candidate skills sets) Manage performance through rewards, recognition, counseling, anddisciplinary action Provide mentorship and career counseling to aspiring cliniciansand leaders so they may develop required skill sets (successionplanning) Identify future skill sets needed to remain competitive Analyze market data in relation to supply and demand and manageresources to ensure appropriate compensation Develop and implement recruitment and retention strategies Strategic Management Analyze the situation and identify strategic direction Conduct SWOT and gap analyses Formulate objectives, goals, and specific strategies related tomission and vision Understand what organizations should measure in order to“balance” the financial perspective Measure and analyze performance from the learning and growth,business process, customer, and financial perspectives Marketing Analyze marketing opportunities Develop marketing strategies Integrate marketing and communications strategies Use public relations and media outlets to promote yourorganization Information Management and Technology Demonstrate basic competency in e-mail, common word processing,spreadsheet, and Internet programs Recognize the relevance of nursing data for improvingpractice Recognize limitations of computer applications Use telecommunication devices Utilize hospital database management, decision support, andexpert system programs to access information and analyze data fromdisparate sources for use in planning for patient care processesand systems Participate in system change processes and utility analysis Participate in the evaluation of information systems in practicesettings Evaluate and revise patient care processes and systems Use computerized management systems to record administrativedata (billing data, quality assurance data, workload data,etc.) Use applications for structured data entry (classificationsystems, acuity level, etc.) Recognize the utility of nursing involvement in the planning,design, choice and implementation of information systems in thepractice environment Demonstrate awareness of societal and technological trends,issues and new developments as they apply to nursing Demonstrate proficient awareness of legal and ethical issuesrelated to client data, information, and confidentiality Read and interpret benchmarking, financial, and occupancy dataSource: The American Organization of Nurse Executives. (2005). AONENurse Executive Competencies. Address reprint permission requeststo aone@aha.org. Attached

 

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