Nurse Executive Leadership

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Nurse Executive Leadership

• AHCA
• October 8, 2008
• Jillene Snow, RN, BSN, MBA
• Nurse Executive Council

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Nurse Executive Council

• Effective nursing leadership of the future will
  require unique skills to manage and lead diverse
  workforces, interpret and execute regulatory
  policy and define parameters of efficient and
  effective practice.

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Collaborative learning outcomes

• Understand the macro-level changes of healthcare
• Recognize how these changes affect long term care
• Identify four specific areas of impact to nursing
  leadership in long term care

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The essence of nursing leadership

• I think ones feelings waste themselves in
  words they ought to be distilled into actions
  which bring results.
• Florence Nightengale
• 1820-1910

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Our Changing Environment

• Key drivers
• Public perception/public discontent
• Financing
• Technological innovation
• Demographics of an aging society

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Focusing on Long Term Care

• Quality is measured in three key performance
  areas
• Consumer satisfaction
• resident and family
• Employee satisfaction
• Workforce Stability
• Clinical Outcomes
• Regulatory Performance

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Our leadership culture

• The Old Way, Regulatory Driven Model/Reactive
• The New Way--Quality Management and Proactive
  Internal Controls to Sustain Compliance Achieve
  Quality Outcomes is the Expectation

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Management vs. Leadership

• Management
• Doing things right
• Urgency
• Speed
• Bottom Line
• Efficiency
• Methods
• Practices
• In the system

• Leadership
• Doing the Right things
• Importance
• Direction
• Top Line
• Effectiveness
• Purpose
• Principles
• On the system

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What is changing in LTC.
specifically

• Customer focus
• Culture Change
• Person-Centered Care
• IOM New Rules - Healthcare for the 21st Century
• Revisions to the State Operations Manual and
  implementation of interpretive guidance
• Quality Initiative in 2006--Advancing Excellence
  in Americas Nursing Homes
• Public Disclosure Quality Outcomes and Customer
  Satisfaction
• 5-Star Rating system

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Institute of MedicineHealthcare in the 21st
Century Concepts

• Health care should be safe, effective,
  patient-centered, timely, efficient, and
  equitable
• We should set national priorities for
  improvement
• We need methods for disseminating and applying
  knowledge to practice
• The use of technology in clinical care must
  improve
• Payment policies should encourage innovation and
• Reward for improvement in performance
• We must enhance education to strengthen the
  healthcare worker.

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Institute of MedicineRules for health care in
the 21st century

• Value Driven
• Care is based on continuous healing relationships
• Care is customized according to patient needs and
  values
• The patient is the source of control
• Care is knowledge driven and information flows
  freely
• Decision-making is evidence based
• Safety is a key component of the system
• Transparency is necessary
• Needs are anticipated
• Waste is continuously decreased
• Cooperation among clinicians is a priority

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What is changing in LTC. specifically

• Workforce
• Demographics of an Aging America
• Pipeline
• Healthcare Professional
• Nursing Shortage
• Physician Shortage
• Education
• Characteristics
• Employee Satisfaction

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What is changing in LTC. specifically

• Financing
• Medicare/Medicaid
• Stability of the Model
• Perceived Waste
• Reward for improvement in performance
• Value-Based Purchasing (P4P)
• changes to acute care will directly affect
  skilled care

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What is changing in LTC. specifically

• Policy/Regulation
• Development of interpretive guidance
• Pilot and implementation of QIS
• Enforcement scrutiny

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• So when do we have time to develop a nurse
  leader?
• When do you have time not to?

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The Hartford Nursing Home Collaborative

• Stabilize, grow and increase the competencies of
  the RN workforce in nursing homes
• Improve the leadership skills, geriatric and
  quality improvement skills of RNs
• Create new care delivery models to meet the needs
  of nursing home population
• Decrease turnover by creating environments where
  RNs desire to work

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The Hartford Nursing Home Collaborative

• Consultation, mentoring and coaching services
• Organizational, knowledge and leadership gap
  analysis toolkits
• Learning collaboratives
• Customized learning and career development

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Sigma Theta Tau International

• Geriatric Nursing Leadership Academy
• Partnership with John A. Hartford foundation
• Goals to produce geriatric nurse leaders who
• Can lead system-wide changes in their respective
  health care settings
• Can develop/implement/evaluate health care
  policies

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Sigma Theta Tau International

• 18-month guided leadership journey
• 4-day leadership workshop
• Fellow Mentor Dyad
• Individual leadership development plan
• Design and manage a team oriented project
• Facilitated visits by Academy faculty