Transforming nursing through knowledge

Professional Accountability: Leadership

Leadership - is a shared responsibility with other nursing leaders and reflects both current and future decision making related to strategic and operational issues.
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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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    This article proposes a comprehensive framework for assessing, reporting and improving the quality of work environments in healthcare organizations across Canada. Healthy work environments (HWEs) contribute to positive outcomes for healthcare employees and physicians. The same HWE ingredients also can reduce operating costs, improve human resources utilization and ultimately lead to higher-quality patient care. We show how health system employers, governments, quality agencies and other stakeholders can implement effective HWE metrics.

    The common reporting framework and metrics we propose enable managers and policy makers to use HWE ingredients as levers to improve organizational performance. Progress requires the active involvement of stakeholders in developing common metrics, the integration of these metrics into existing measurement and reporting systems, the building in of managerial accountability for work environment quality and support for ongoing improvements at the front lines of care and service delivery.

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    Improving clinical nurse work environments is a major challenge faced by nurse executives today. To meet this challenge, nurse leaders must implement the “right” structures and best leadership practices so that clinical nurses can engage in the work processes and relationships that are empirically linked to quality patient outcomes. What are these “right” structures and best leadership practices?