CNOs are coming together to face three challenges that are heavily impacting the nursing industry.
This year started off with a bang for healthcare and the chaos has continued. From the ever-changing landscape of technology to the uncertainty surrounding healthcare policy, CNOs have a lot to consider when thinking about the future of the nursing industry.
Many nurse leaders are nervous about AI implementation and how to move forward with diversity, equity, and inclusion (DEI) policies, all while addressing the typical staffing and wellbeing concerns.
From April 14-16, the members of the HealthLeaders CNO Exchange will meet in Nashville, Tennessee, to talk about how to meet these challenges head-on.
Virtual nursing and AI
To fill in workforce gaps, health systems everywhere have been implementing virtual nursing and AI technologies.
Virtual nursing allows nurses to spend more time at the bedside while alleviating administrative and documentation burdens, such as admissions and discharges. As virtual nursing becomes the standard of care across the industry, the Exchange participants will discuss what comes next for virtual nursing, how to measure outcomes, and how to overcome implementation barriers.
AI is still a nebulous concept for many, with endless possibilities and opportunities for use. However, there are some serious concerns among nurse leaders about documentation errors, lack of transparency, and deskilling among the workforce. The Exchange members will also discuss how to properly implement AI into nursing workflows and how it should be controlled and regulated.
Policy and advocacy
Many CNOs are unsure how to proceed with policy as the Trump administration continues to throw executive orders at the wall to see which ones stick. As of right now, nothing regarding DEI policy has been made illegal, but with so much public scrutiny of the term, health systems are already taking steps to comply with what might happen.
At the Exchange, the participants will discuss how nurses and nurse leaders can get involved with policy and lawmakers to advocate for the nursing profession. For instance, CNOs must connect with their representatives and build those relationships so that legislators have nursing experts that they can turn to when making policy decisions.
Succession planning
Lastly, CNOs are struggling to build the next generation of leaders due to labor shortages, retention challenges, and the aging workforce.
The Exchange participants will discuss how to find and encourage nurses to go into leadership and how to incorporate mentorship and training time into staff schedules. They will brainstorm ways to find diverse, highly-qualified candidates, and ways to partner with nursing programs to present leadership as a desirable career path.
Lastly, the members will share how they are funding succession planning initiatives and getting buy-in from CFOs, CEOs, and HR leadership. There's lots more to come from this year's CNO Exchange, so stay tuned for more coverage.
The HealthLeaders Exchange is an executive community for sharing ideas, solutions, and insights. Please join the community at our LinkedIn page.
Two U.S. Senators have co-sponsored a bill that would create a better pathway for Medicare coverage of FDA-approved AI tools for clinical care.
One of the barriers to AI adoption in clinical care is the lack of a clear financial ROI. A new bill before Congress aims to make that process a little bit easier.
U.S. Senators Mike Rounds (R-South Dakota) and Martin Heinrich (D-New Mexico) are sponsoring the Health Tech Investment Act (S.1399), which would expedite the pathway to Medicare reimbursement for clinical AI tools.
“Medicare patients deserve access to the life-changing care that artificial intelligence-enabled devices can offer,” Rounds said in a press release announcing the bill. “There is currently no clear Medicare payment system for these devices, meaning that it can take years to be approved and paid out by Medicare accurately. This legislation would create that system, improving diagnoses and encouraging the adoption of AI devices in clinical settings.”
The fast-paced development of AI tools in the healthcare space has created a noticeable gap between implementation and governance. According to Rounds and Heinrich, the FDA has approved more than 600 AI-enabled devices, but the Centers for Medicare & Medicaid Services (CMS) “lacks standard or consistent methods for covering and paying for these products.”
And without reimbursement, providers are reluctant to adopt the technology. Many health systems and hospitals, particularly non-profits and rural organizations, are operating on razor-thin margins, and executives won’t likely introduce new tools unless CMS backs them financially.
The bill has garnered support from several advocacy groups, including the National Health Council and the Advanced Medical Technology Association (AdvaMed).
“AI’s role in improving patient care is already evident and increasing, particularly in radiology, where AI can help doctors and other healthcare professionals swiftly analyze medical images, detect illness and abnormalities, and make a more informed diagnosis,” AdvaMed said in a press release. “Moreover, FDA authorized AI-enabled medical devices are poised to save the healthcare system resources due to enhanced diagnostic and therapeutic precision that can help drive efficient and effective care.”
“With AI-enabled medical technologies already making remarkable strides in patient care, and with even more incredible strides ahead of us, now is the time to establish a predictable reimbursement pathway,” Scott Whitaker, the group’s president and CEO, said in the release.
This week's Winning Edge panel explored how ambient AI is being introduced to clinicians, and how the technology will evolve as a decision support tool.
Health systems like Providence and Cedars-Sinai are taking a slow and steady approach to introducing ambient AI to their clinicians, with small pilots that gradually scale upward as doctors become familiar with the technology.
During this week's The Winning Edge podcast, sponsored by Microsoft, Providence Chief Transformation Officer Sara Vaezy and Cedars-Sinai CMIO Yaron Elad, MD, FACC, said the biggest ROI for ambient AI at present is in helping clinicians reduce their administrative workload and spend more time in front of patients.
But they also noted that the technology will eventually become sophisticated enough to give clinicians near-real-time clinical decision support, while also helping to identify and schedule tests and appointments and code the encounters.
Both said it's important to put AI in the hands of doctors who want to use the technology, so that they can demonstrate its value and pass that on to their colleagues. And while the potential to reduce workflow pressures and find time to see more patients may be there, executives shouldn't be suggesting that to their doctors.
Ambient AI is just one of several AI tools being introduced in the clinical space, according to Vaezy and Elad. Health systems and hospitals are also testing the technology on in-box messaging, with the goal of reducing time spent by clinicians checking their messages and answering patient requests more quickly. They're also trialing AI on chart summarization, and looking forward to applying AI to nursing.
Watch the YouTube video below of this week's panel to gain more insight into how AI is being embraced in the clinical space.
This week’s Winning Edge panel explored how ambient AI is being introduced to clinicians, and how the technology will evolve as a decision support tool.
For innovative CNOs who want to crack the code for nurse wellbeing, there might be a hairy solution.
HealthLeaders spoke to Beth Steinberg, associate director of research at the OSU Center for Integrative Health and founder of the Buckeye Paws program, about the Buckeye Paws program and how dogs can be a powerful tool for nurse wellbeing. Tune in to hear her insights.
Healthcare executives who took part in this week’s Winning Edge panel say ambient AI is helping clinicians reduce administrative stresses, but it will soon be used to add value to the patient encounter.
Health systems like Providence and Cedars-Sinai are embracing ambient AI to improve clinician workflows and reduce administrative tasks, but the real value will come when AI adds clinical value to the doctor-patient encounter.
That’s the long view taken by executives from the two health systems during Tuesday’s The Winning Edge panel, sponsored by Microsoft. And it points to the future of Ai in clinical care as a decision support tool.
Sara Vaezy, Chief Transformation Officer at Providence, and Yaron Elad, MD, FACC, Cedars-Sinai’s Chief Medical Information Officer, said their organizations have both gradually rolled out ambient AI tools to physicians to help them spend less time in front of a computer and more time in front of their patients. The technology is designed to accurately capture the conversation and put that information into the medical record, reducing the amount of time clinicians spend documenting the encounter.
Elad said it’s reasonable to expect that the tool reduces time spent on the computer by 10% to 20%, especially time spent after hours, even at home, tidying up the notes for the patient record. That reduces the clinician’s administrative workload and gives the doctor more time to face the patient—something that not only benefits the doctor, but makes the patient feel more valued as well.
That might not appeal to a CFO looking for financial ROI, but it does set the foundation for improved provider well-being, better patient engagement and satisfaction, and eventually improved clinical outcomes.
That said, the two executives and Jared Pelo, MD, CMIO for Microsoft’s Health and Life Sciences unit, pointed out that clinicians have to “own” the technology and have the time to get used to it on their own terms. Healthcare leaders should not tell them that AI will improve their productivity, such as giving them more time to see new patients; instead, as clinicians settle into their new workflows, they may find the time to address new productivity goals.
Vaezy said Providence is tracking several different metrics on ambient AI, including efficiency and appointment times, to get a baseline on how the tool could have an impact on productivity in the future. Just as important, they’re charting provider and patient satisfaction, and asking clinicians if they’d be disappointed if the tool were taken away, whether they’d recommend AI, whether this tool improves documentation and would this capability compel them to stay with the organization or stay in medicine.
Both Providence and Cedars-Sinai are developing AI tools in other areas as well, including in-basket messaging and chart summarization. And while Vaezy and Elad said the next big advances should come in how AI can be used to improve nurse workflows, both are particularly looking forward to how AI evolves as a clinical decision support tool.
Vaezy pointed out that AI, for the most part, is now being used to reduce complexity and remove administrative burdens, but within two to three years the technology’s value will be in adding to the provider’s toolbox and giving more value to the provider-patient encounter. That might mean coding the encounter and identifying and pushing tests and other appointments.
Elad, meanwhile, said he envisions an AI overlay that gives clinicians almost real-time clinical decision support. This would support the true definition of AI as augmented, rather than artificial, intelligence.
Stay tuned to HealthLeaders this Friday for the YouTube recording of this Winning Edge panel.
A Cedars-Sinai program attaches a substance abuse treatment doctor and social worker to the patient’s care team, improving treatment adherence and creating a better link to post-discharge treatment.
Cedars-Sinai is championing a new care management strategy aimed at linking patients dealing with substance abuse issues to medication-based treatment services after they’ve left the hospital.
The Los Angeles health system’s Substance Use Treatment and Recovery Team (START) pairs an addiction medicine specialist with a social worker or case manager to coordinate post-discharge care plans, including diagnostic assessments, information on treatments, psychosocial support and follow-up phone calls for one month.
The program builds on care transformation strategies that health systems and hospitals are exploring in an effort to redesign inpatient care and boost clinical outcomes. The idea is to create a personalized care team around the patient that includes clinicians and specialists and which can be expanded to include others such as pharmacists and social workers.
“Our program addresses a major challenge across hospitals,” Itai Danovitch, MD, chair of the Department of Psychiatry and Behavioral Neurosciences at Cedars-Sinai, said in a press release. “Even though effective medications exist for opioid use disorders, only a small percentage of hospitalized patients begin treatment during their stay or connect with services after discharge.”
According to a study authored by Danovitch and recently published in JAMA Internal Medicine, patients introduced to START were more than twice as likely to accept medication-based treatment during their hospital stay than those receiving the usual care, and they were almost twice as likely to embrace treatment after discharge.
Those numbers are important as health systems and hospitals try to battle the ongoing substance abuse epidemic, an integral part of the surge in mental health cases and a contributor to crowded Eds and declining public health outcomes.
The study, led by Cedars-Sinai, analyzed 325 patients hospitalized at three hospitals—one in Los Angeles, one in Albuquerque, New Mexico and one in Springfield, Massachusetts—between November 2021 and September 2023, with a final follow-up in December 2023.
Of that group, 164 patients received START care and 161 received traditional care. More than 57%, or 94, of the START patients initiated medication-based treatment (naltrexone, buprenorphine or methadone) during their hospital stay, compared to almost 27%, or 43 of the traditional care patients, and 72%, or 90, of the START patients continued care after discharge compared to 48%, or 50, of the traditional care patients.
“Hospitalization provides a crucial window to involve patients in addiction treatment when they might be most open to it, particularly after experiencing health-related consequences of their substance use,” Jeffrey A. Golden, MD, director of the Burns and Allen Research Institute and executive vice dean for Research and Education at Cedars-Sinai, said in the press release. “These important findings show how the medical community can significantly boost this engagement and help find solutions for the national opioid epidemic.”
In 2025, CNOs need to begin leveraging social media as a tool for connection with their workforce and the public.
According to Rebecca Love, chief nursing officer and nurse influencer, and Dr. Marion Leary, nurse innovator and also a nurse advocate, there are several steps that CNOs can take to begin getting comfortable with posting online.
First and foremost, Leary recommended understanding what point of view you want to post from. Leary also suggested starting with a buddy, or someone you can run posts by before hitting 'send' or 'schedule.'
Leary and Love's third tip is to distinguish between your personal and professional social media, and to decide which you're going to post as. Love also recommended leaning into your nursing expertise and into the subject matters that you're most passionate about. The most important part as well is to actually engage with the audience.
Sharp HealthCare's year-old virtual nursing program is now testing a 'VIP experience' that enables nurses to become more active members of the patient care team.
As virtual nursing programs mature in health systems and hospitals across the country, some executives are envisioning a concierge care strategy.
Sharp HealthCare, for example, debuted its VIP platform roughly two months ago in the neuroscience unit in preparation for the opening of the new Sharp Grossmont Hospital for Neuroscience. This expanded co-caring model known as Vitual InPatient nursing services (VIP) leans heavily on patient engagement strategies, with the goal of having the virtual nurse as the patient's guide through the healthcare journey.
Tracy Plume, Nurse Director for the San Diego-based health system, says the new model was co-designed by patient advisors, information technologists and front-line nurses.
"The patients really want to know that someone was behind the scenes monitoring their record, looking at their chart, that nothing was going missed," she says. "They felt that that would make them feel safer, that their care was progressing as it should be. And that they had the opportunity to daily meet with the virtual nurses and ask those questions."
"They get an extra connection with the nurse, a healthcare provider, someone on the care team, to help coordinate that admission to discharge process." Plume adds.
Plume and Susan Stone, Sharp HealthCare's SVP of Health System Operations and System Chief Nursing Executive, recently took part in HealthLeaders' Virtual Nursing Mastermind program. Executives from roughly a dozen health systems met virtually and at an in-person event in Atlanta to discuss how their programs are evolving, where they see challenges, and how this strategy will evolve.
For Sharp HealthCare, virtual nursing is more about care delivery transformation, or crafting a new strategy for inpatient care that involves all the members of the care team. The idea took root in 2023 after a board member witnessed how Providence (another Mastermind participant) was transforming its care team strategy. Stone says she and her colleague spent a year researching the concept and looked at roughly 20 virtual nursing programs across the country.
Roughly one year ago, on April 1, 2024, Sharp launched its first virtual nursing program in two selected units, focusing primarily on handling admissions from the Emergency Department and discharges. The program has now spread to all four of Sharp's hospitals, encompassing about 600 licensed beds and 16.2 FTEs and running seven days a week, 12 hours a day.
Stone says the program focused on admissions and discharges first because those were the key pain points identified by frontline nurses who were included in the planning process. Sharp built is ROI strategy, she says, on reducing those time-consuming processes, thereby improving patient throughput and freeing up beds faster for new patients (Stone says the health system is runs between 85-95% capacity, making available inpatient beds a valuable commodity).
Stone says developing and proving an ROI is daunting, considering the many pain points that a virtual nursing program can potentially address. While patient throughout is one of them, she says, there are many factors beyond the nurse's control that go into how long a patient stays in the hospital.
Susan Stone, SVP of Health System Operations and System Chief Nursing Officer, Sharp HealthCare. Photo courtesy Sharp HealthCare.
"We're still working hard on producing and defending the return on investment," she says.
Other factors include readmissions (a costly pain point for every health system), nurse workflows and well-being, and patient satisfaction and engagement.
And that's where version 2.0, the so-called VIP experience, comes in. Stone and Plume say Sharp leadership wanted to target the patient experience in the evolution of virtual nursing, with a service that creates a care program around the patient.
"We've really taken our program past services and alleviating that administrative burden on the nurse to really being more part of the care team," Plume said.
Plume says the patient experience should always begin "with a warm hug," a feeling that the patient is being cared for by a team, both in the hospital room and behind the scenes. Through the virtual portal, a nurse is keeping an eye on the patient's healthcare data, coordinating with other members of the care team and the patient's family, handling administrative duties and funneling education and other resources to the patient.
She says nurses like the format because it gives them an opportunity to stay in the loop and learn more about their patients.
Whether this program can be expanded to all hospitals at Sharp depends on ROI, which will take time to develop. Stone notes that patient satisfaction rates have soared since the program's inception soaring, a good sign that they're more engaged with the care team and understanding their care at home management plan.
In addition, Stone says discharges are much more timely, and when recently speaking with frontline nurses, they report being able to facilitate patient discharged by 11:30 whereas before it would have been into the late afternoon to facilitate three discharges by themselves.
They are now looking at the possibility of folding other services into the virtual nursing platform, including deterioration alerts, sepsis alerts and the potential to be more efficient with virtual sitting throughout the system. Others have suggested adding virtual visits by specialists, such as diabetes educators.
"To us the future is for all different types of virtual care, and we know that other smart programs will be deployed via the electronic health record system, and we haven't really launched them to their fullest extent," Stone says.
"All of those things are business cases that we need to take one at a time," she adds. "We don't want to go too fast too soon because that could set the program up for failure."
The HealthLeaders Mastermind program is an exclusive series of calls and events with healthcare executives. This Mastermind series features ideas, solutions, and insights on excelling in your AI programs.
To inquire about participating in an upcoming Mastermind series or attending a HealtLeaders Exchange event, email us at exchange@healthleadersmedia.com.
To stay on top of the nursing narrative, CNOs must jump at the opportunity to connect with the public and with their own staff through social media.
In the realm of social media, many CNOs are late to the game.
The narrative surrounding nursing has run away from nurse leaders, and while there isn't a way to completely own a narrative on social media, it's not too late for CNOs to jump into the conversation.
According to Rebecca Love, chief nursing officer and nurse influencer, and Dr. Marion Leary, nurse innovator and also a nurse advocate, it's important for CNOs to be on social media themselves.
"[CNOs] have this knowledge and leadership skillset that really needs to be seen by nurses across platforms," Leary said at the AONL 2025 conference.
Why CNOs should post
According to Leary, partnering with influencers is one way to enter the narrative, but the more effective method is to join social media directly. CNOs across the country are all trying to address similar issues, so forming relationships on social media and collaborating is a great way to help solve problems.
"Make sure you're on LinkedIn especially," Leary said. "Create a profile and just document what you do on a day to day, like what the struggles are that you're seeing at your institutions and then making sure that you're engaging with other CNOs across the country."
Love referenced the Woodhull Study on Nursing and the Media, which found that nurses were cited as sources in only 4% of health news stories 20 years ago. The revisited study in 2018 stated that nurses are the source of only 2% of quotes in articles, and were never sourced in stories on health policy.
"So, what that's telling you is 98% of relevant news stories go to others to speak on behalf of nursing," Love said. "CNOs must participate because other people are writing the narrative about nursing without nursing."
Love explained that traditionally, nurses were told they couldn't speak about the profession because of HIPAA, which Love identified as incorrect.
"Most people are getting their news now from social media and the older traditional ways of journals and publishing are not the ways to engage with the population and scale," Love said. "If we are going to advance our profession, we need to move forward by doing that on the platforms that are engaging with the front line of humanity, which is social media."
Many reporters will also use social media as a way to find industry voices and experts, which is another reason why CNOs must engage on those platforms.
"The truth is that the power of social media to drive change and drive good on behalf of the work we do is exactly what is necessary, because fundamentally, that is our goal, is to alleviate suffering and to fight for humanity," Love said.
Shifting the narrative
While the publicity surrounding nursing can be quite negative, it's important that CNOs and other nurse leaders try to pivot the narrative to show the broader impacts of the nursing profession.
"Nursing is a wealth of different experiences and knowledge, we're not just one thing," Leary said. "Yes, we work at the bedside, but we work in policy, we work in research, we do innovation and startups, all these things that are attributed to other fields and professions, nurses are doing those things and leading in those spaces."
To Love, CNOs need to provide a counternarrative to the negativity coming from many frontline nurses on social media. Both CNOs and frontline nurses want the same things for nursing, like better outcomes, conditions, pay, and a future for the profession.
"The truth is that bridge is only going to get wider, that gap is going to get wider until [CNOs] get on social media and start creating an open, honest dialogue that creates a counternarrative to what these nurses are experiencing, but also transcending where we want nurses to go because I think that there is shared mission and vision," Love said.
Getting started
Love and Leary both provided posting tips for CNOs who are just getting started. First and foremost, Leary recommended understanding what point of view you want to post from.
"You have to understand and create your own persona for social media," Leary said. "What I am on social media is not necessarily what I am off of social media, and you have to be okay with creating that persona and leaning into it."
Leary also suggested starting with a buddy, or someone you can run posts by before hitting 'send' or 'schedule.'
"For CNOs, having a buddy within their health system would be helpful so that you're always keeping your health system's priorities in mind," Leary said.
Leary and Love's third tip is to distinguish between your personal and professional social media, and to decide which you're going to post as.
"You've got to pick your persona on social media, either you're representing the institution you are, or you're representing the person you are," Love said. "I would strongly suggest you represent the person you are."
Love also recommended leaning into your nursing expertise and into the subject matters that you're most passionate about. The most important part as well is to actually engage with the audience.
"You get what you put out and what you give," Love said. "If you just post and don't engage with others, people aren't going to engage with you. Social media is a two-way street."
Lastly, Learn emphasized the importance of being kind online.
"Be nice," Leary said. "Don't engage with trolls and negativity, it just never works out."
