Nursing Administration Quarterly最新文献

Successful organizations depend on strategic thinkers who understand strategic planning and strategic management. These strategic leaders can proactively manage the constant environmental changes to position their organizations for a competitive advantage and avoid acting in a reactive and defensive manner. However, while organizations are often adept at developing extensive strategic plans, implementation of the plan is often poor or without a definitive strategy. This article addresses key strategies for successful implementation of changes to bring about sustainable cultural change in an organization to meet the organization's overall strategic goals, specifically through the use of implementation science.

Nursing is a demanding profession that calls for nurses to devote time, energy, advocacy, and compassion to improving clients' lives while providing safe, efficient care. Nurses make personal sacrifices to meet their clients' needs, which do not come without costs to their well-being. An increased migration of novice nurses out of the profession and the need to increase the volume of the nursing workforce by an average of 8% annually to address the projected nursing shortage presents a compelling need for immediate action. Reimagining the concept of academic-service partnerships to provide exposure to opportunities that can equip and empower novice nurses as they emerge into professional practice cannot be underestimated. Implementing approaches to assess, support, and nurture the health and well-being of nurses and health care organizations is foundational to retention.

The COVID-19 pandemic has been blamed for multiple health system problems. Many of the current issues, including staffing shortages, while exacerbated by the epidemic, have plagued us for decades. Various reactionary solutions to nursing shortages have been implemented during periods of crises, only to be abandoned when shortages have become less acute. Root causes for the resulting chronic shortages of nursing care team members have not been widely addressed. Nurse leaders have a responsibility to current and future patients, communities, and caregivers to mitigate these while implementing solutions to the current acute crisis in staffing. This requires an organization's nursing enterprise to define a vision for a preferred future, a strategic plan, and specific tactics to address the current crisis while ensuring sustainability of solutions. This article shares a high-level example from one of the country's largest health care systems.

Addressing today's challenges in nursing requires a new mindset and a renewed commitment to improving the quality, safety, and equity of health care. Together, this approach can achieve truly transformational change in nursing that will last for generations. Setting visionary, future-oriented goals can draw upon key scholarship from the past as well as from fresh thinking on what is needed to improve health care at every level. Nurses are essential in this pursuit, given their central role in providing direct care and their leadership role in codesigning new models and systems of care.

The nursing profession is at a paradigm shifting moment. The cracks in the profession and the health system were exacerbated by the global pandemic of COVID-19 and chronic workforce issues. Nursing must explicitly acknowledge the broken systems and work specifically to address them. Through innovation leadership, health care leaders can identify the issues and create novel solutions to lead nursing into our desired future.

As hospitals are experiencing a nursing shortage, nursing leaders must build innovative partnerships and strategies between nursing and recruitment to close the workforce gap. One large health care system was experiencing a high vacancy rate. To improve recruitment and retention efforts, nursing leaders partnered with the recruitment department and other key stakeholders to develop strategies. Together, they designed a candidate-centric recruiting and hiring process, designed innovative recruitment campaigns including recruiting former employed nurses, recruitment of traveling nurses into employees, increased graduate nurse recruitment efforts, and implementation of a registered nurse (RN) Ambassador program. The team improved work process efficiency for recruiters and candidates. Retention efforts focused on engaging nurses in the work environment, decreasing nurse leader workload to allow a focus on staff relationships, and improving exit processes in an effort to retain the nurse. The actual vacancy rate was as high as 20.9% in July 2021 to 8% in September 2022, indicating the system is closing the vacancy rate and nearing the goal of 5%.