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Q&A: Nurse Leaders on Affecting Outcomes Through Leadership

Alexandra Wilson Pecci, for HealthLeaders Media, February 26, 2013

Watland: [The term] "nurse leader" takes on a whole new meaning. And I don't mean the formal leader, the chief nurse or even the director level...we have to cultivate nurse leaders at all levels of the organization.

I think at the bedside, there are many nurses that can be taught leadership tools, and how to do peer coaching, to make sure that we're holding each other accountable for complying with good standards, good practices.

I think we have to incorporate the whole meaning of nursing leadership at all levels within the organization, and have them really take an active role. Taking more of a leadership role at the bedside, in addition to what we traditionally think about as formalized management type of leadership roles. I think we really need to cultivate the clinical leadership as well with nurses that are at the bedside.

HLM: Can you share some real-world examples of how you've done that successfully?

Watland: Over about 18 months we identified nurses in each unit who wanted to be involved and had the ability to kind of take on more of this [leadership] role, and we taught them tools on how to apply research, how to do tests of change, how to gather data/analyze data, how to apply these evidence based standards, and we focused it around sepsis morality with a goal of reducing sepsis based mortality.

So with this model, nurses were able to learn how to use these tools, they learned how to coach their peers. They learned how to hold each other accountable in a very professional and respectful way, and we were able to then infuse that kind of model into all the different units.

And that it's not just the manager of that unit that holds each other accountable to complying with those practices and those standards...the staff became engaged in that practice. That was very successful, and now we're expanding that to other goals that we've established for other quality indicators and also customer service, or patient experience indicators and outcomes.

We're going through that same process, using those same tools, and [asking ourselves] how do we apply that, then, to other goals we have for improving outcomes in the unit. The staff have really stepped up to be involved at the level. They get education on how to do those kinds of things...it's really using evidence-based practice and then the tools that are generated through that to hold each other accountable, and then they measure outcomes.

And if something's not working, they change it, and then they test [to find out if] this is working better, and they've learned how to do that process. It's really quite exciting.

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