The nurse executive acts as the “chief” nurse in their organization and is mandated to govern, as well as lead and direct practice. To depict this, the “Framework for Nurse Executive Leadership” organizing framework is encircled by three bands of responsibility: Governance, Leadership and Practice.
In their governance role, the nurse executive participates as an active and engaged member of the board/senior management quality committee and as such champions policies and protocols that promote effective, quality and evidence based health care delivery.
- The nurse executive assumes accountability for monitoring data collection on nursing-sensitive quality indictors and communicates these results to the board/senior management team.
- The nurse executive leads the team in meeting quality and safety performance targets and provides evidence-based standards and recommendations. The link between nursing work environments and nurse/client and organizational outcomes is clearly articulated to the board/senior management team.
- Structure, process and nursing-sensitive outcome indicators are presented and supported by the nurse executive for inclusion in organizational quality improvement plans.
In their leadership role, the nurse executive proposes, leads and directs strategies to improve quality outcomes and advance evidence-based care/services.
- The nurse executive oversees and reports on risk management strategies and participates on task forces/ad-hoc committees as necessary and appropriate.
- A culture of learning is promoted through the implementation and evaluation of clinical and healthy work environment best practice guidelines and quality improvements that are consistent with the organization’s broader quality improvement plan.
- The development, implementation and evaluation of data collection, measurement and analysis tools and strategies are led by the nurse executive, ensuring the most effective use of informatics to inform nursing practice and organizational effectiveness.
In their practice role, the nurse executive role models vigilance in providing and ensuring high quality care through:
- Leading the team in assessing variability in nursing practice within the organization in order to determine areas in which the quality of care through use of best evidence might be improved and risks to patient safety might be decreased.
- Evaluating nursing practice from a structure, process and outcomes framework and selecting appropriate outcomes for measuring progress towards organizational healthcare delivery goals.
- Facilitating the implementation and evaluation of clinical and healthy work environment best practice guidelines while monitoring the organizational processes and change this creates; keeping in mind the impact of each on nurse/client, organizational and societal outcomes.