Transforming nursing through knowledge

Professional Accountability: All Resources

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    5 Critical Organizational Strategies For Creating a High Performing System
     
    1. Quality as a Core Strategy
    2. Development of organizational skills to support performance improvement
    3. Effective Effective learning learning strategies strategies and methods methods to test and scale up 
    4. Information as a platform for guiding improvement
    5. Leadership systems that embrace common goals and align activities throughout the organization
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    This five-part editorial series examines the Institute of Medicine’s (IOM) most recent report, “The Future of Nursing: Leading Change, Advancing Health.” Each issue through July targets one of the four IOM global recommendations for expanding nursing practice and positively impacting healthcare systems of the future.
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    In April 2011, the Federal Government published draft regulations regarding the implementation of Section 3022 of the Affordable Care Act, which contains provisions relating to Medicare payments to providers of services and suppliers participating in accountable care organizations. It is important for the nurse executive to understand these proposed regulations and how they may impact the provision of nursing care should the organization for which the nurse executive works decide to become or join an accountable care organization.
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    Nurses play an integral role in the delivery of quality care in the home. Home nursing care is the promotion of health, assessment, provision of care and treatment of health conditions by supportive, preventive, therapeutic, palliative and rehabilitative means in order to attain or maintain optimal function (Havens 2003). Home health nurses are committed to the provision of accessible, responsive and timely care which allows people to stay in their homes with safety and dignity (Community Health Nurses of Canada 2010). 
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    The Blueprint for Action for Community Health Nursing in Canada outlines a national framework and action plan for the current and future development of community health nursing in Canada. This Blueprint is the product of collaboration and is intended to provide diverse stakeholders including educators, policy-makers, leaders in health services administration, researchers and community health nurses, among others, with a framework to guide decisions and activities that promote and protect the health of Canadians. 
     
    It will be used as an advocacy tool, and as a guide to direct coordinated action to manage the strategic changes and actions essential to promoting, protecting and restoring the health of all Canadians. The framework is a living document − a starting place for discussion and continued interprofessional and intersectoral collaboration. Different communication strategies and tools will eventually emanate from the Blueprint to address concerns and issues of various partners in action.
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    This knowledge synthesis has been compiled on behalf of the planning committee for a Think Tank entitled “Toward a National Report Card for Nursing.” The objectives of the Think Tank are to create a shared vision and critical path for a national report card on nursing, to generate support for the work, and to outline the steps to achieve the national report card.
     
    The report card for nursing is envisioned as a selected minimum set of data on input, process and output indicators that can be collected nationally (initially using pilot sites) and benchmarked. In the future, such report card data will be used to formulate relationships between the levels of indicators, and will consequently reveal the contribution of nursing care to nursing sensitive outcomes and influence policy direction for nursing. 
     
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    The Ontario Public Health Organizational Standards (Organizational Standards) establish the management and governance requirements for all boards of health and public health units. Similar to the Ontario Public Health Standards (OPHS) 2008, which outline the expectations for providing public health programs and services, the Organizational Standards outline the expectations for the effective governance of boards of health and effective management of public health units. Organizational Standards help promote organizational excellence, establish the foundation for effective and efficient program and service delivery and contribute to a public health sector with a greater focus on performance, accountability and sustainability.
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    Professional practice models (PPMs) provide a conceptual framework for establishing professional nursing practice. According to the American Nurses Credentialing Center’s Magnet Recognition Program, a PPM is a schematic description of a system, theory, or phenomenon that depicts how nurses practice, collaborate, communicate, and develop to provide the highest quality of care for those served by the organization. Integrating a PPM into the nursing practice arena may require complex organizational change. One strategy for integration is to directly link the PPM with performance expectations, thus ensuring that the underlying principles are supported and evident in everyday practice. This article describes the development, implementation, timeline, and successful outcomes of a clinical advancement system (CAS) that was aligned with a newly adopted PPM.
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    The ability to influence others is a required competency  for nurse executives trying to achieve positive patient/organizational outcomes. The Adams Influence Model (AIM) is a framework for understanding the factors, attributes, and process of influence. The AIM is grounded in nursing and organizational literature and provides nurse leaders with a road map for developing an effective strategy to achieve influence with individuals and/or groups. The authors describe the AIM and present a case study illustrating  its application by a chief nurse executive.

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    Our “Blueprint for Nursing Leadership” emerged from dialogue with our nurse leaders on the daily challenges that managers encounter with competing and compelling priorities in the increasingly complex health care environment. Recognizing this as a transformational opportunity the reorganized nurse executive council members were invited to a leadership retreat to further explore this topic. From this dialogue, 3 key components, distributed responsibility, nonstop skill development, and accountability became the framework on which the “Blueprint for Nursing Leadership” was crated. The blueprint is to empower, engage, and sustain a culture of accountability.