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Articles, case studies, and success stories to guide and inspire healthcare HR, Organizational Development, and Clinical professionals.


UTMB Invests in Developing Patient Care Facilitators and Nurses Catalyst Learning

When the University of Texas Medical Branch (UTMB) assessed its training needs in late 2015, nursing leadership recognized a gap in charge nurse development. With no formal tools in place and a somewhat inconsistent structure to the Charge Nurse position, UTMB decided to take action. Catalyst Learning's NCharge® courses were chosen to bring more commonality and consistency to this vital hospital role for both current and aspiring Charge Nurses. To date, 60 participants in three cohorts have completed all five NCharge courses: Charge Nurse Fundamentals; Critical Thinking; Leading Change in a Dynamic Climate; Supervisory Skills for Positive Outcomes; and Employee Engagement & The Patient Experience.  Patient Care Facilitators (PCF), who have similar responsibilities to Certified Clinical Nurse Leaders, have also been included in this comprehensive professional development program. Because Charge Nurses often look to PCFs as experts on the patient care experience, UTMB determined that leadership training could equally benefit the PCF role, said Barbara Bonificio, Director of Nursing Excellence. Bonificio added that the NCharge program could become an important asset in a comprehensive health system initiative to increase employee engagement and patient satisfaction. In fact, UTMB leaders believed the program was valuable enough to include some of its relevant results at the unit level in UTMB's recent reapplication for Magnet status.

Improving Outcomes

By putting in place formal training, UTMB hopes to make significant improvements not only in patient satisfaction, but also RN-to-RN communication, nurse sensitive indicators and workflow on the units. Comparisons of participant surveys conducted before classes began and after completion indicate positive movement in critical skills development across several of these areas.  

Most notably, when asked if they were cognizant of the key drivers of positive patient experience, only about 65% of respondents strongly agreed when surveyed before taking classes. After completion of the program, more than 85% strongly agreed with that statement. When asked if they understood the linkage between employee engagement and the patient experience, nearly 90% strongly agreed after the course, up from less than 70% before entering the program.  Also, only about 60% of respondents strongly agreed they were cognizant of key drivers of an engaged team prior to NCharge. That number jumped to close to 90% after completion.

A Timely Decision

When UTMB launched NCharge in December 2015, hospital staff was preparing to relocate to a new facility and would be faced with a new set of workflows. The program's Leading Change module proved to be timely, as all participants in the class were involved in this major move.  One especially valuable component of the Leading Change module educated students about the change curve, demonstrating that workers at different levels in an organization also are at different stages of the curve, said Sharon Hensley, Nursing Program Manager. Those in leadership roles may have already processed a change, while frontline workers may have just been introduced to it. "That was very impactful for them," she said.   Prior to taking the Leading Change class, only 55% of survey respondents strongly agreed they were cognizant of their role to assist the team with change management. After completion, nearly 90% strongly agreed. In terms of leadership, 100% of respondents reported strong agreement that they were cognizant of their influence on the attitude and tone of the unit, up from only 60% prior to the class.

Additional Benefits

Beyond these targeted outcomes, NCharge has been successful in helping to dispel some misconceptions and illuminate different perspectives. For example, before the courses, many participants believed value-based purchasing simply meant that if system departments bought in volume, UTMB got a discount. "The financial impact of value-based purchasing was a real eye-opener for everyone," said Bonificio. "I don't think they realized the significant dollar amounts attached to not being reimbursed, as well as the penalties for not reaching certain targets."  

Because each cohort comprised a mix of experienced Charge Nurses and those hoping to land the role, NCharge was beneficial to both groups because they were exposed to each other's perspectives. In addition, the module on types of communication is already being put to use on the floor. "Participants learned the best way to talk to people whose communication styles are different than their own," said Bonificio. Now, graduates are "excited to share the skills they have learned with their units." 

 

Looking to the Future

Reception to the NCharge program has been overwhelmingly positive overall, Hensley said. "There were significant dollars connected to the people being selected, and I think that was impressive to them - that we are investing in them."  UTMB nurse leaders are happy with the program response and results so far, and plan to continue offering it to PCFs and Charge Nurses. In fact, they envision further advantages across other nursing roles. "It would be beneficial if all nurses could understand challenges their charge nurse colleagues face," according to Bonificio. "If everyone understood these challenges, it would make the units run much more smoothly."




It’s Time to Be Deliberate About Nursing Leadership Succession chardyadmin
Nursing leadership and nursing management often are used as interchangeable terms, but they refer to two different things. Put simply, nurse leaders help influence a hospital’s high-level strategy, while nurse managers are charged with executing that strategy on a day-to-day basis. 

According to HRSA, about one-third of RNs are over age 50, and most nurses in leadership positions are even older. As this segment of the work force begins to retire, it’s a mistake to assume that first-level nurse supervisors and nurse managers will be ready to take over for your facility’s CNO without a deliberate succession plan in place. 

The Evolution of Nursing Leaders
The path to nursing leadership has evolved in recent years. In the past, nurses only took on administrative responsibilities once they had proven themselves in a clinical setting — an advanced degree in management was not required. Today, the nursing leadership landscape demands that nurses seek out business expertise in addition to clinical training, including degrees and certifications, if they hope to be promoted to a leadership role. As such, healthcare organizations must be more proactive than ever in steering nursing professionals toward the management track.

Unfortunately, many health systems and hospitals still are deficient in their succession planning efforts, according to the National Healthcare Leadership Index survey conducted by National Center for Healthcare Leadership (NCHL). Only 8 percent of nursing leader respondents reported they received “a great deal”’ of succession planning.

Grooming Leaders From Within
Succession planning should comprise the careful process of identifying and nurturing a pool of internal candidates as emerging leaders. Ideally, current leaders should become mentors to this group, grooming them with intention. The candidates should have easy access to continuing education resources and professional development opportunities, and they should be encouraged to take advantage of them. Aside from valuable institutional knowledge, developing new leaders from within your organization just makes good financial sense — it is much more costly to replace a high-ranking officer from the outside than develop an internal candidate. 

According to Medscape, a top characteristic to look for in prospective nurse leaders is the potential to be a “transformational leader.” These people are adept at identifying needed changes, guiding those changes by inspiring others, and instilling a company-wide commitment to make change happen. Transformational leadership has been shown to improve nurse satisfaction at the unit level, promote a positive work environment and reduce turnover. According to AONE, nurse executive leadership competencies should also include foundational thinking skills, personal journey lessons and systems thinking. 

Mitigating the Stress of Succession
Because there likely will be a major transition among nursing leadership during the next decade, NCHL offers best practices to minimize and mitigate the trauma of this transition. Effective succession planning should be integral to the hospital’s culture and foster clear communication that stresses succession planning as an organizational priority. NCHL also recommends involvement and ownership in succession planning by senior management; use of a leadership competency model; rigorous assessment of leadership candidates with a focus on retaining them; encouraging those candidates to stretch their skills and perspectives; implementing formal professional development plans that emphasize on-the-job training; and ongoing measurement and evaluation to ensure the succession plan is on track.

In order to assure continuity of nursing leadership, a seamless transition at retirement, minimal financial impact and uninterrupted staff and patient satisfaction, hospitals must be strategic in their succession planning sooner rather than later. Start planning for the future of your facility today.

 

SOURCES:

http://bhpr.hrsa.gov/healthworkforce/reports/nursingworkforce/nursingworkforcefullreport.pdf#sthash.PUGzTCxa.dpuf

http://bhpr.hrsa.gov/healthworkforce/rnsurveys/rnsurveyfinal.pdf

http://www.nchl.org/Documents/Ctrl_Hyperlink/doccopy5800_uid6102014456192.pdf

http://www.nchl.org/Documents/Ctrl_Hyperlink/doccopy5322_uid11420131046251.pdf

http://www.medscape.com/viewarticle/771912_2

http://www.aone.org/resources/nec.pdf





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