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Q&A: Nurse Leaders on Affecting Outcomes Through Leadership, Part II

Alexandra Wilson Pecci, for HealthLeaders Media, March 5, 2013

HLM: What about nurse leaders themselves who are feeling overwhelmed?

Davis: Participation in networks and collaboratives, both at a state, regional, and national level, really do help in looking at benchmark performance; understanding how you compare to your peers does help bring clarity and focus to what you need to do.

And not unlike the challenges of the staff nurse, we have to practice what we're preaching so to speak, and really be able to clarify what are the priorities on our agenda and how to we move that forward.

So for me, that focus and discipline around the key things and really trying to find those high leverage points [is important]. Like what we were describing about staff involvement and ownership of the work helps you in many, many ways.

So how can you think through your tactics to say what will really help us move our agenda overall forward and what are the specific things we need to be doing?

Watland: The biggest challenge for me, and I think most people in healthcare is how do you continue to raise the bar and provide the best quality outcomes for the lowest price you can?

Because the resources for reimbursement… [are] going down, we have more people to provide care for, and quality is certainly absolutely one of the biggest challenges and goals that we all have.

To go back to how do you do that, you mentioned about confused and overwhelmed, and I think you do get overwhelmed if you start thinking about that in an isolated or siloed fashion.

But we can't do that. We have to be collaborative. We have to network. We have to work as a team. I think in the last few years, I have seen more collaboration and teamwork, and interdisciplinary kinds of work going on between physicians and nurses, and all of the ancillary services and nursing, coming together in an integrated manner to tackle these issues and together we need to be an extension for one another we need to make sure that we're providing the care that we need to provide.

It used to be more siloed than it is now. And I think our new and especially our younger healthcare professionals are really looking to do this as a more collaborative model and really respecting each other as they do it. In leadership, in senior leadership, we have an obligation to foster that and to cultivate that culture and making sure that we're working in collaboration to do this. This is not nursing's challenge alone. Nursing has a huge [role], and we provide the majority of care in a hospital setting. We have a huge obligation to have a voice, but we also have a huge obligation to have a collective voice with the other disciplines, and I think that's one of the things that I really try to foster here.

Because you can get so much more done if you're working together.

Davis: I would totally agree. A more tangible way that we're doing that [is] we're in the process of preparing to change our electronic health record from one vendor to another, and our new opportunity with the new vendor is to really bring together the inter-professional team in a way where we're really looking at the care process.

How are we doing the work for our patients together? How are we eliminating unnecessary duplication? How are we sharing information better? For us, that's been a very tangible way and coming together as a clinical governance overseeing the redesign of our EHR in a really tangible way that will directly impact what we do every day.

I couldn't agree more that this is a team sport, and I think as Judy said, these are not nursing's issues alone. It's a requirement that we not only model, but really engender the high levels of collaboration that are required to move us forward.

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