Journal: Nursing administration quarterly
Frontline managers in health care are the keepers of culture, the gateway to evoking a grass roots intelligence network, and they hold a pivotal role in advancing innovation at the point of care. Their roles are ever expanding and include knowledge and skills in managing the business, leading the people, and advancing their own leadership development. In all 3 areas, the impact of their leadership exponentially increases if they maximize innovative thinking and action. Health care executives need to establish the expectations for an innovative culture and the role of frontline managers. They must model the behaviors they promote and take the time to develop these frontline managers who are the hub for innovative success in the organization. This article offers insights and practical applications while exploring the innovation keystones of the following: creating an organizational culture of innovation, igniting collaboration that fuels diverse thinking and creativity, utilizing meaningful data to drive innovative decisions, and assessing and monitoring the ongoing climate and outcomes of innovation.
The evolution of care delivery from an acute care and inpatient standard to the outpatient setting and health promotion model is generating the need for innovative workforce and infrastructure adjustments to meet the new paradigm of population health management. Successful transformation of the nursing workforce necessitates a positive style of thinking that addresses rational concerns during times of difficult transition. Nurse leaders are called to recognize and appreciate the strengths of the nursing workforce by involving them in the course of change through collaboration, planning, and discussion. One unique way to plan and develop new care delivery models is to adopt the framework used in health facility planning and design for new services, units, or hospitals. This framework is flexible and can be adjusted easily to meet the objectives of a small nursing workforce innovation project or expanded to encompass the needs of a large-scale hospital transformation. Structured questioning further helps the team to identify barriers to care and allows for the development of new concepts that are objective and in accord with evidence-based practice and data. This article explores the advantages and disadvantages of implementing innovative workforce redesign and workforce reduction strategies.
To explore and derive new conceptual understanding of nurse leaders' experiences and perceptions of caring in nursing.
Coopetition, the simultaneous pursuit of cooperation and competition, is a growing force in the innovation landscape. For some organizations, the primary mode of innovation continues to be deeply secretive and highly competitive, but for others, a new style of shared challenges, shared purpose, and shared development has become a superior, more efficient way of working to accelerate innovation capabilities and capacity. Over the last 2 decades, the literature base devoted to coopetition has gradually expanded. However, the field is still in its infancy. The majority of coopetition research is qualitative, primarily consisting of case studies. Few studies have addressed the nonprofit sector or service industries such as health care. The authors believe that this article may offer a unique perspective on coopetition in the context of a US-based national health care learning alliance designed to accelerate innovation, the Innovation Learning Network or ILN. The mission of the ILN is to “Share the joy and pain of innovation,” accelerating innovation by sharing solutions, teaching techniques, and cultivating friendships. These 3 pillars (sharing, teaching, and cultivating) form the foundation for coopetition within the ILN. Through the lens of coopetition, we examine the experience of the ILN over the last 10 years and provide case examples that illustrate the benefits and challenges of coopetition in accelerating innovation in health care.
Whether natural or human-induced, disasters are a global issue that impact health care systems' operations, especially in the acute care setting. The current COVID-19 pandemic is a recent illustration of how health care systems and providers, especially nurses, respond to a rapidly evolving crisis. Nurse leaders in the acute care setting are pivotal in responding to the multifactorial challenges caused by a disaster. A quality improvement project was developed to increase nurse leaders' knowledge and confidence in disaster management during the COVID-19 pandemic at 2 Magnet-designated acute care hospitals within the John Muir Health system in Northern California. A total of 50 nurse leaders initially participated in this project, with 33 participants completing the postintervention survey. Results indicated significant improvement in perceived knowledge and confidence in disaster management after the intervention. Qualitative responses from project participants highlighted the need to annualize educational opportunities to sustain knowledge and consistently review emergency management operations plans. This quality improvement project provided an approach to educating nurse leaders in disaster management to promote resilience, support of employees, and optimal patient outcomes during disasters.
When the Covid 19 pandemic affected New York State, Federal and mostly State, mandates were given to hospitals to prepare for the expected influx of patients. This is a community hospital’s planning journey that includes preparing for placing patients, educating caregivers, matching the abilities of the available caregivers with the needs of the patients, securing needed equipment and supplies, and caring for the caregivers. Planning for patient placement resulted in a phased-in guide, accommodating seriously and critically ill affected patients. Education and training were initial and ongoing, rapidly changing as new information became available. Effective care delivery models that focused on team were modified depending on the needs of patients and staff competence. Securing and maintaining equipment and supplies were challenging and caring for the caregivers was a priority. Working as a team, this community hospital developed a road map that was effective in planning for the surge and allowed the hospital to maintain a safe environment for staff and patients who received quality care in difficult time.
As hospitals across the world realized their surge capacity would not be enough to care for patients with coronavirus disease-2019 (COVID-19) infection, an urgent need to open field hospitals prevailed. In this article the authors describe the implementation process of opening a Boston field hospital including the development of a culture unique to this crisis and the local community needs. Through first-person accounts, readers will learn (1) about Boston Hope, (2) how leaders managed and collaborated, (3) how the close proximity of the care environment impacted decision-making and management style, and (4) the characteristics of leaders under pressure as observed by the team.
Postacute care is a term used to describe a group of health care providers, caring for patients outside of traditional acute care. The populations served and measures of outcomes are similar, but the services provided may vary by type of setting and individual provider. Managing through the coronavirus disease-2019 (COVID-19) pandemic has been both a challenge and an opportunity to demonstrate the vital role of postacute providers in the health care continuum. National media outlets have highlighted emergency departments, critical care areas, and start-up COVID units in acute care hospitals treating critically ill patients battling COVID-19. Stories of nursing homes in crisis over the rapid spread of COVID-19 have saddened readers of newspapers and social media alike. Postacute providers have experienced the pandemic alongside the acute care hospitals in ways that have highlighted the flexibility of postacute care, challenged leaders to lead with intensity, and demonstrated their importance in the continuum of care. Through a series of interviews with postacute care leaders, this article explores the response to the pandemic from the perspective of providers in postacute care settings.
The COVID-19 pandemic has affected millions of Americans, including health care staff. This article traces the experience of 1 nurse leader as she falls ill, only to learn that she has, indeed, been infected with the virus. She describes her 4-week quarantine, including the impact on her family and her attempts to continue to support her staff. As she recovers from the acute onslaught of COVID, the focus shifts back to her nurse leader role. In this role, she and her colleagues manage the logistics of caring for more than 150 COVID-positive patients a day in the 719-bed academic medical center. This included staffing the hospital, given the extreme challenges of staff availability limited by concerns such as school closings and at-risk family members. Now with the hospital’s daily volume of COVID-positive patients greatly reduced, there is an opportunity to reflect on lessons learned, including what went well during the peak of the crisis and where there were opportunities. Leadership and staff are experiencing a sense of pride at their exceptional care of this complex population, even while exploring opportunities to be even better prepared should COVID erupt once again.
The COVID-19 crisis created unique and interesting challenges for health care systems and changed how health care professionals delivered care. Evidence suggests that leadership skills remain of utmost importance during crises as it is the leader who often determines the response of the follower. A descriptive qualitative approach was used to ascertain the essence of nurse executive leadership and innovation during the COVID-19 crisis. Nurse executives were recruited via personal invitations to participate in the study. Participants were asked about their current challenges of COVID-19 on health care delivery, their leadership style, and what innovative processes their teams deployed. Using a thematic analysis approach, 3 themes emerged and resonated from the interviews: the importance of communication; the need for leadership presence; and mental toughness. With any health care crisis, leadership is essential to guide followers. As demonstrated by these findings, communication, leadership presence, and mental toughness are 3 key components to promoting and providing quality care in an austere, complex, and changing health care environment. Further understanding of the roles of these key concepts may add insight into nurse leaders and leadership development.