PREPARING NURSE

LEADERS FOR

TRANSFORMATIVE

ROLESMargaret Blastorah, PhD, RN Lisa Cranley, PhD, RN

Lynn Nagle, PhD, RN Susan VanDeVelde-Coke, PhD, RN

Leslie Vincent, MScN, RN Michael Villeneuve, MSc, RN

OBJECTIVES

1. To understand the theoretical foundation and structure of a new graduate nursing leadership program

2. To appreciate the linkages among leadership demands and challenges, program curriculum, and program delivery approaches

AIMS

• Develop and deliver a program to prepare nurses for formal leadership roles in healthcare systems in Canada and internationally

• Graduates (would be) prepared for careers in health care administration, health policy, professional practice leadership, and other related roles

HOW WE GOT HERE

• Internal Review of MN program (Price, 2012)

• Anecdotal feedback from students and graduates

• Analysis of evolving leadership and administration context

• Increasing complexity of roles, organizations and systems

• Varying models of care, funding arrangements, information management processes

• Financial challenges

• Diverse interprofessional teams

• Consideration of changes in population of current and future students

• Younger, early career

• High users of technology-enabled communication

• Expectations regarding work-life-school balance

CONCLUSIONS

Inconsistent preparation and outcomes from “menu-driven” program format

Need for additional core knowledge and skills in HR, financial management, strategic thinking, emerging leadership approaches and theories

Perceived imbalance between theory and application

Leverage technology for program delivery (while retaining student-faculty connection)

More structured, consistent, relevant program to prepare nurse leaders

Learners needed increase exposure to leadership roles and practice opportunities (practicum)

Hybrid delivery format (combination of online and on-campus learning activities)

CREATING THE TEAM

• Faculty teaching in legacy MN-Administration program

• Adjunct faculty with expertise and experience as nurse leaders/executives

• Chief Nurse from TAHSN hospital

• Other consultation as needed

• Dean and Associate Deans

• TAHSN nurse leaders and executives

• Bloomberg Hospital-University Nursing Education Committee (HUNEC)

WHERE TO START????

• Some idea about strengths and gaps of legacy MN-Administration program

• Lots of ideas about topics, but a bit of a “laundry list”

• Needed an over-arching structure to identify essential content, scaffold learning and skill development, ensure relevance in 21st century

• Recognized that a single theory or framework would be inadequate

• Selected 4 relevant frameworks:CNA Advanced Practice Nurse framework (2009) – foundational to all our MN programs

Carol Huston’s 8 nursing leadership competencies for 2020 (2008)

LEADS framework (CCHL)

AONE Nurse Executive Competencies framework (2004)

INTEGRATION AND ALIGNMENT OF FRAMEWORKS –

OVERLAPS AND COMPLEMENTARITY

LEADS (CCHL) CNA Advanced Practice Huston’s 2020 Competencies AONE Nurse Exec

Competencies

Lead Self Coping effectively with change

A global perspective/mindset

Balance authenticity and performance expectations

Leadership skills

Professionalism

Engage Others Ability to identify learning needs of individuals and teams,

and finding or developing programs to meet them

Mentoring and coaching

Articulating a vision of professional nursing practice and

aligning nursing with organizational vision

Collaborating with team to develop QI and risk

management strategies

Apply theories related to group dynamics, roles and

organizations

Engaging clients and team members in resolving issues

at the individual, organization, and system level

Collaborative and team building skills

Balance authenticity and performance expectations

Communication and relationship-building

Leadership skills

Achieve Results Identifying and resolving complex problems in

organizations and systems

Managing and leading change and transformation

Program evaluation

Prioritizing quality and safety

A working knowledge of technology

Expert decision-making skills rooted in empirical

science

Business skills

Develop Coalitions Building effective coalitions

Demonstrating expertise in communication, negotiation,

and conflict management

Understanding legislation and socio-political dynamics

influencing health policy and building strategies to

improve health, access to health care, and healthy public

policy

Being politically astute

Systems

Transformation

A broad, effective set of advocacy skills Knowledge of the health care environment

ITERATIVE PROCESS OF CONTENT DEVELOPMENT

Identification of competencies

Grouping into meaningful units, coherent courses

Checking against competency map

Considering/debating dependencies and pre/co-requisites

HSLA SUGGESTED CONTENT

Accreditation

Advanced practice in nursing management functions, including

o Delegation

o Stress management

o Time management

Advocacy skills

Care delivery systems and models

Communication with diverse clients, groups, stakeholders and

situations

Conflict management

Critical thinking and integrative thinking, decision-making,

problem-solving

Data management, analysis, synthesis, interpretation and

translation in advanced nursing practice

Determinants of health and population health status

Development of goals, objectives and a vision for nursing

practice

Diversity

Ethical decision making, with a focus on management ethics

Evaluation of programs and systems

Evidence-informed practice and decision making

Fundamentals of care

Global health policy/systems

Health human resources management and development,

including:

o Assessment of work environments and their impact on staff

o Creating and maintaining work environments conducive to

organizational effectiveness

o Collective bargaining and union relationships

o Disciplining and terminating staff

o Evaluating staff performance

o Performance management

Evaluating performance

Mentoring and coaching staff

Motivating and developing employees

Managing performance/practice issues

(incompetence, incapacity, misconduct,

absenteeism)

Workplace relations and incivility

Discipline and termination

Managing absenteeism, workplace incivility,

employees with problems

Motivating and developing employees

o Recruitment

o Retention

Health system economics and financing

Heath system governance, legislation, legalities and

accountability

Health systems and organizational performance

Health-care organization accounting and finance

Healthy public policy

History of nursing (including leadership and advanced practice,

evolution of ideas and approaches, philosophy)

Information systems and technology

Interprofessional practice

Initiating, leading and managing change, innovation, and

transformation in complex programs and systems

Leading committees and task forces

Leadership principles, theory and practice

Leadership of self

o Attitude

o Emotional intelligence

o Influence

o Interpersonal communication

o Motivation

o Personal and professional accountability

o Political intelligence

o Professionalism

o Self-control

o Trust

o Problem-solving

Mentoring, coaching and evaluating individuals

Nursing research in advanced nursing practice

Nursing systems

Operations management, managerial tools and tactics

Organizational theory, structures and environment/culture

Patient safety, quality outcomes, errors and risk management

Philosophy (history/evolution of major perspectives, including

but not limited to philosophies of science, health, society,

management)

Power, influence and political action

Preparing and understanding budgets

Problem solving and innovation in complex organizations and

systems

Professional nursing practice models (including staffing, skill

mix and scheduling)

Program development, management and evaluation

Public policy and politics

Relationship management and interpersonal collaboration

Self-management including delegation, time management and

stress management

Strategic thinking and planning health care

Structure, organization and history of reform in Canada’s health

systems

Team building, management and interpersonal collaboration

Theoretical foundations for advanced practice

CURRENT PROGRAM STRUCTURE

Year Fall Winter Spring

Year 1 • History of Ideas in

Nursing Practice

• Research Appraisal

and Utilization Part 1

• Theories and

Concepts in Nursing

Leadership and

Administration

(Includes one week

on-campus residency)

• Research Appraisal

and Utilization Part 2

• Leading and

Managing Effective

Healthcare Teams

(Includes 80 h.

practicum)

Year 2 • Advanced Topics in

Management and

Leadership

• Health Systems,

Policy and the

Profession

• Program Planning

and Evaluation

• Practice Scholarship

Final Practicum (170

h.) with Leadership

Project

Includes 2-day on-

campus residency

ONGOING REVIEW AND “RE-MAPPING”

(WINTER 2017)NURSING LEADERSHIP COMPETENCIES FOR 2020 (Huston, 2008) 1017 1027 1127 1151 1152 1016 1034 1161 1072

A global perspective/mindset X X X X

A working knowledge of technology X X X X

Expert decision-making skills rooted in empirical science; X X X X X X X

Prioritizing quality and safety X X X X X X

Being politically astute X X X X

Collaborative and team building skills; X X X X X X X

Balance authenticity and performance expectations; and X X X

Coping effectively with change X X X X X X

OUTCOMES TO DATE

Feedback from students and graduates (anecdotal and survey):

Confidence in nursing leadership abilities

Applying for and securing leadership positions and undertaking organizational projects

Student recruitment:

Building awareness and interest within and beyond Southern Ontario

Students have participated from Alberta, Nova Scotia, Middle East, UK

Current students referred to program by previous students

QUESTIONS??

MN-HSLA Year 1 Residency Mar. 2017