Six C’s to effective nurse leadership

The ANMJ describe the six C's for the most effective nurse leadership: communication; confidence; creating cohesion; courage; conflict resolution; and commitment to excellence.

Nursing requires competent, confident leadership. No matter where you are in your career, you should be reflecting on your existing leadership skills and identifying areas where you can improve.

Read the full article here for more information.

                                                                       Picture source: ANMJ

Transformational change in health and care

This recent Kings Fund report offers insights to help strengthen transformation efforts by looking at four sites in the UK that have been recognised as successful transformation initiatives.
The stories of Bromley by Bow, Birmingham, Northumbria and Buurtzorg illustrate that transformation is multi-layered, messy, fluid and emergent. It is not merely about changing how a service operates, but also about shifting mindsets, changing relationships and re-distributing power.
The report shows the power of staff and communities to drive transformation: the importance of giving people time and space to think through the purpose of transformation; to understand the struggles and worries they face; to offer support instead of demanding change with no time to prepare or engage.

Transformational change in health and care: Reports from the field. 2018 

Using appreciative inquiry as a framework to enhance the patient experience

The following case depicts the journey of a non-profit hospital in the US and its attempts to turn around suffering patient experience. The Hospital turned to the theories of Appreciative Inquiry and the power of a strengths-based approach to create a framework to support the patient experience initiatives. Hospital leadership led the formation of a Patient Experience Team to implement ten initiatives in order increase the top box score in the domain of willingness to recommend the hospital, as that was selected as a global measure of success for the overall improvement project.

Moorer, Kerry [et al] (2017). Using appreciative inquiry as a framework to enhance the
patient experience, Patient Experience Journal,  4(3), Article 18. 

Greater nurse autonomy associated with lower mortality

This study published in the Journal of Nursing Scholarship provides evidence that when nurses do not have the ability to exercise their clinical and organisational knowledge, patient safety is put at risk. A professional work environment links to improved patient, personnel and organisational outcomes.
Therefore, it is possible that healthcare organisations are responsible for providing the necessary means for nurses to act autonomously by: formulating clear roles, responsibilities and behaviours; enhancing competence in practice and decision-making; using shared governance organisational structures; and by creating strong visible leadership.

Rao, Aditi D, Kumar, Aparna, McHugh, Matthew. (2017). Better Nurse Autonomy Decreases the Odds of 30-Day Mortality and Failure to Rescue. Journal of Nursing Scholarship, 49(1), 73-79 (this article is freely available to MNCLHD staff)   

Social Work Leadership and Management

The Australian Association of Social Workers’ (AASW) Scope of Social Work Practice series provides an overview of the role, scope and contribution of social work practice. This document on leadership highlights the crucial role and services that social workers provide and that employers and clients can expect. Social workers, policy makers, managers and academics can use this scope of practice to articulate and promote the role of professional social workers in this field.

Scope of Social Work Practice: Leadership and Management. Australian Association of Social Workers. 2016

Nurses and Professional 'Silos"

This article looks at a healthcare experience through a different lens, from that of a healthcare professional entering hospital as a patient.

As healthcare providers we each work within our specific area of expertise or what may be referred to as our “silo.” Each silo is rich in research, knowledge, experience, and expertise regarding best practices for quality patient care. Each silo also assumes that the other healthcare silos always know, respect, understand, and implement their expert advice and wisdom. However, after this 21-plus day experience as a patient’s family member, not as the healthcare provider, it was perceived that each of the wide array of health care “silos” work alone and are not in collaboration with each other. In addition to the fragmentation, there is no unifying body pulling all the parts together to create this individualized quality healthcare experience so often discussed in not only the literature, but also in every healthcare system’s mission statement. Is it the nurse’s responsibility to ensure that quality patient/family centered care is provided by knocking down these silos and unifying care?

Nurses Must Knock Down Professional "Silos" and Create Quality, Safe and Effective Interprofessional Teams. From the Inside Looking Out: A Healthcare Providers Experience Being the Family Member. Journal of Nursing & Care, 5(3). 

Speak Up: Easier to Say than Do

Have you ever made a mistake? This short article in the open access Journal of Perioperative & Critical Intensive Care Nursing states that hospitals are no strangers to mistakes either,  In fact, it is well known that errors occur regularly which can lead to patient harm and unnecessary financial costs borne by the healthcare system. By upholding the expectation that nurses speak up, organizations can improve patient safety. Factors such as leaders who are good role models and organizations that reward speaking up can be built upon to strengthen a hospital’s culture of safety.

2016. Speak Up: Easier to Say than Do, Nicole Hall.  Journal of Perioperative & Critical Intensive Care Nursing. doi:10.4172/jpcic.1000111

Patient Safety: a Compendium of Reports

The Lucian Leape Institute of the [US] National Patient Safety Foundation have compiled a compendium of the executive summaries and recommendations from five of their reports as a resource for health care leaders. The five reports are: 

• Shining a Light: Safer Health Care Through Transparency (2015)
• Safety Is Personal: Partnering with Patients and Families for the Safest Care (2014)
• Through the Eyes of the Workforce: Creating Joy, Meaning, and Safer Health Care (2013)
• Order from Chaos: Accelerating Care Integration (2012)
• Unmet Needs: Teaching Physicians to Provide Safe Patient Care (2010)

Transforming Health Care: A Compendium of Reports from the National Patient Safety Foundation’s Lucian Leape Institute. Lucian Leape Institute at the National Patient Safety Foundation, Boston, 2016. http://www.npsf.org/lli/transforming-health-care            

Translating clinical leadership into quality improvement

The presence and/or absence of effective leaders in health care can have a stark consequence on the quality and outcomes of care. The delivery of safe, quality, compassionate health care is dependent on having effective clinical leaders at the frontline. This article in the Journal of Healthcare Leadership explores some ways of translating clinical leadership into health care quality improvement. This is achieved by exploring what is clinical leadership and why and how this is important to health care quality improvement, clinical leadership, and a duty of candor.  The article also discusses the importance of clinical leadership in the provision of quality care improvement and outcomes.

McSherry R, Pearce P. (2016). What are the effective ways to translate clinical leadership into health care quality improvement? Journal of Healthcare Leadership, 2016(8), 11-17. 

Download the free article here.

Engaging the Medical Staff

"There are three main reasons why hospital leaders need strong medical staff leaders as allies. First, medical staff leaders are more influential with their peers than managers are. Second, they serve as the leadership team’s main connection to frontline doctors. Finally, they provide essential advice and input on hospital initiatives to the organisation's management team."

A recent publication from The Advisory Board Company suggests from recent research that hospitals do not have a strong doctor engagement. You can read and learn how focusing on communication, leadership development, and staff enfranchisement can change the relationship you have with your doctors, and cement truly great medical staff engagement across your organisation.

You can download the study here or check with your library if they have the book for loan. The Advisory Board Company. Engaging the Medical Staff. Partnering With Doctors to Achieve Mutual Goals

The practice of system leadership: Being comfortable with chaos

This report published by the Kings Fund looks at the challenges facing the NHS in England, and what type of leadership skills are needed to be a system leader. The system needs leaders who can motivate staff and managers to work differently, across service and organisational boundaries. That is the only way to meet the needs of the growing number of people with complex and long-term conditions, many of whom rely on care and support from different services.

The Practice of System Leadership. The Kings Fund 2015    

Developing collective leadership for health care

This paper from The King’s Fund in the UK argues that collective leadership – as opposed to command-and-control structures – provides the optimum basis for caring cultures. Collective leadership means everyone taking responsibility for the success of the organisation as a whole – not just for their own jobs or area. This contrasts with traditional approaches focused on developing individual capability.  It also implies that all staff welcome feedback, and treat complaints and errors as opportunities for learning.  There should be collective openness to and learning from errors, near misses and incidents.

The interaction between collective leadership and cultures that value compassionate care are explained by drawing on wider literature and case studies of good organisational practice. The main characteristics of a collective leadership strategy and the way to develop it are outlined.   

Why leadership-development programs fail

This issue of the McKinsey Quarterly looks at why leadership initiatives fail. The report identifies the four most common reasons that programs fail and gives tips to overcome them.

Why leadership-development programs fail.  Sidestepping four common mistakes can help companies develop stronger and more capable leaders, save time and money, and boost morale. 

January 2014 | byPierre Gurdjian, Thomas Halbeisen, and Kevin Lane. Mckinsey Quarterly

Nursing Leadership

The Journal of Nursing Management has published a special issue titled "Global Nursing Leadership". All of the articles are free to download.

Special Issue: Global nursing leadership Issue editors: Pamela Thompson and Kristiina Hyrkas, January 2014. Volume 22, Issue 1

High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs

The US Institute for Healthcare Improvement (IHI) has published a 34-page white paper based on  the findings of an IHI 90-Day Innovation Project on leadership.
In the white paper the authors discuss three interdependent dimensions of leadership that they consider define high-impact leadership in health care.

The white paper also includes examples from a variety of health care leaders, to help illustrate High-Impact Leadership Behaviors in real-world practice.

Swensen S, Pugh M, McMullan C, Kabcenell A. High-Impact Leadership: Improve Care, Improve the Health of Populations, and Reduce Costs. IHI White Paper. Cambridge, Massachusetts: Institute for Healthcare Improvement; 2013.