This CNO says a healthy work environment is crucial to building a sustainable health system.
A large part of nurse dissatisfaction involves working in poor conditions. Nurses are overworked because of staffing shortages, they’re exhausted by heavy workloads, and they’re often dealing with workplace violence and other external disruptors.
A healthy work environment is necessary for nurses to thrive, and for patients to get the highest quality care and experience when visiting a health system. We sat down with Deana Sievert, Chief Nursing Officer at Ohio State Wexner University and Ross Heart Hospitals, to learn more about how CNOs can create better conditions for their nurses.
Betty Jo Rocchio, Senior Vice President and Chief Nurse Executive at Mercy, chats with nursing editor G Hatfield about the impacts of AI in nursing, and how CNOs can implement and integrate AI into nurse workflows to benefit both the nurse and the patient.
Health systems and hospitals are using more and more new technology to address clinical care gaps. That puts a strain on execs charged with making sure they’re safe and secure
Healthcare cybersecurity standards need to be strict for a reason: Compromised technology could lead to a patient’s harm, even death. But when a health system uses technology from a vendor, sometimes those standards aren’t the same.
“That’s a challenge,” says Adam Zoller, chief information security officer at Providence.
“As a large hospital system, we are relying on hundreds of third parties,” he says. “And when some of those devices are 100% vendor-managed, they often won’t modify anything,” making it much harder for the health system to ensure that technology can be used safely and securely.
“Cyber incidents affecting hospitals and health systems have led to extended care disruptions caused by multi-week outages; patient diversion to other facilities; and strain on acute care provisioning and capacity, causing cancelled medical appointments, non-rendered services, and delayed medical procedures (particularly elective procedures),” the HHS report, issued in December 2023, noted. “More importantly, they put patients’ safety at risk and impact local and surrounding communities that depend on the availability of the local emergency department, radiology unit, or cancer center for life-saving care.”
Zoller has nothing but good things to say about the federal government’s efforts to improve cybersecurity, particularly in elevating the responsibilities of the National Institute of Standards and Technology (NIST). And while many vendors in the clinical space are taking steps to better secure their technology, the rapid advance of AI and digital health is prompting health systems and hospitals to partner with companies outside the healthcare industry—companies with different philosophies around security.
“There needs to be more accountability,” he says.
Health systems like Providence spend a lot of time addressing cybersecurity through these devices—even when the vendor isn’t responsive to making changes on their end. Those are time-and labor-intensive projects that a smaller hospital or health system might struggle to accomplish, and which could be avoided if the organization and vendor could just work together.
This is an issue that has plagued healthcare for years. The gradual advance to consumer-facing care and the introduction of consumer-facing technologies and strategies has created a gap between those devices and clinically validated technology. In other words, health systems and hospitals have been looking at the consumer tech space with an eye toward expanding healthcare opportunities, but they’re wary of the value of the data coming from these devices as well as the safeguards in place to protect that data.
For Zoller, those gaps exist in any technology using commercial operating systems. Clinical technology, he says, is designed for a longer life-cycle, while commercial tech operates on shorter life-cycles and relies more heavily on updates and patches (which also add to the revenue stream). But each of those updates and patches represents another security risk that healthcare organizations have to address before those changes can go live.
“If I’m still having to educate the vendors who produce these devices about security [every time there’s an update}, that’s a real problem,” says Zoller.
Now multiply that by the number of vendors are large hospital system like Providence works with, and the problems become even bigger.
“We are very dependent on those third parties,” Zoller says, “so the biggest challenge for me is in managing third party risk at scale.”
To be clear, this is an industry issue, not just a Providence issue. The American Hospital Association has been advocating for better cybersecurity safeguards for this party vendors for years, and large health systems like Providence are a part of that effort. But Zoller notes his voice is one of many, and while the big guys have the resources to manage multiple third-party partnerships, smaller health systems and hospitals are stretched thin and apt to have more issues.
Likewise, with the evolution of smart devices and the smart home and an increase in remote patient monitoring and acute care at home programs, “the complexity you’re introducing to a healthcare ecosystem increases the risks,” Zoller adds.
He says healthcare organizations “are on the receiving end” of more and more technologies that don’t meet clinical cybersecurity standards because the industry is embracing new tools and concepts that have proven themselves in other markets, like retail. What might be a great new platform that boosts clinical care in the home setting might also be a security nightmare.
Zoller wants the federal government to extend its cybersecurity guidelines to vendors in the healthcare space who manage their products on commercial operating systems, to bring them to the table to discuss with healthcare organizations how their technology can better adhere to clinical cybersecurity standards. He says the new HHS cybersecurity guidelines set a good baseline that health systems and hospitals can use when working with vendors.
“We need to look at where the equities are aligned,” he says. “It is great that we’re beginning to see more of these conversations around security … but more needs to be done.”
The introduction of disruptors into the healthcare industry could have an effect as well. Companies like Amazon, Google, Apple and Microsoft are introducing healthcare services and products that aim to give consumers a choice as to where and how they get their healthcare. Given those options, consumers could look for services and platforms that better protect their data.
“The disruptors in this space could see security as a differentiator,” he says. “That could certainly make a difference.”
A healthy work environment is critical to maintaining sustainable health systems.
A large part of nurse dissatisfaction involves working in poor conditions. Nurses are overworked because of staffing shortages, they’re exhausted by heavy workloads, and they’re often dealing with workplace violence and other external disruptors.
A healthy work environment is necessary for nurses to thrive, and for patients to get the highest quality care and experience when visiting a health system.
Here’s what CNOs need to know about healthy work environments, according to Deana Sievert, Chief Nursing Officer at Ohio State Wexner University and Ross Heart Hospitals.
A recent HealthLeaders AI NOW panel discussed how the technology is being applied to clinical care
Health systems and hospitals are seeing specific benefits from deploying AI technology in clinical care, according to executives taking part in a panel at the recent HealthLeaders AI NOW virtual summit.
While much of the so-called “low-hanging fruit” has so far been tied to back-end and administrative tasks, AI tools have been used with considerable success in radiology, where the technology can pick up details in images that can improve diagnoses. And AI is also being used in places like the Emergency Department, inpatient care, and population health programs.
“Financial ROI is important, but it’s not the only factor that health systems should be focusing on,” said Jared Antczak, chief digital officer at Sanford Health.
The rapid pace of development for AI tools in healthcare is tied to the potential for the technology to solve a wide variety of healthcare’s biggest problems, but without a good enterprise-wide strategy in place, some organizations are launching projects with an uncertain ROI and putting pressure on executives to find value after the fact. Advocates suggest launching small AI programs at first with a defined ROI, especially in areas where the value is clear.
In other words, think before you act.
“AI is not and should not be a strategy in and of itself,” Antczak said. “It’s a potential tool that can be used to solve a problem. But really tools are enablers of strategies, not strategies by themselves. We need to avoid the trap of doing technology for the sake of technology and really leverage technology to create value in people’s lives.”
“Knowledge is expanding faster than our ability to assimilate it and apply it effectively,” he added. AI is “a powerful tool that can sift through the noise and the information overload and really help clinicians by lifting up the things that matter.”
Albert Karam, vice president of data strategy analytics at the Parkland Center for Clinical Innovation, a research institute allied with Dallas-based Parkland Health, said the health system is using a predictive AI tool in Emergency Departments at Parkland Hospital and University of Texas Southwestern Medical Center to assess patients’ mortality over the next 12 to 72 hours, to determine when patients are scheduled for surgery.
“The idea here is that the orthopedic surgeons … use that information to decide whether to take [those patients] into surgery,” he said. “If things are looking a little bit grim … they might … try and get some of those metrics better before taking them in.”
Karam said the score developed by the AI tool is comprised of many data sources and updated hourly.
“It’s one of the life-and-death models [that is] a little bit morbid but incredibly useful,” he said. “They were literally having yelling matches in the hallway between the orthopedic surgeons and some of the other surgeons to decide whether or not to take them into surgery, and that has completely gone away.”
Another AI tool, focused on evaluating a patient for sepsis risk, was introduced in the inpatient setting, Karam said. It worked so well that executives in oncology and OB-GYN asked to have it reconfigured for their departments as well, and just recently the tool was reconfigured again to address whether sepsis is present in a patient on admission in the ED.
Antczak said Sanford Health has several predictive AI tools in use with clinical applications, addressing such issues as risk of colon cancer and chronic kidney disease.
“We’ve developed a number of different algorithms around disease state progression and anticipation to really enable our clinicians and our patients to potentially intervene sooner,” he said.
“Sometimes that word ‘healthcare’ is a bit of a misnomer,” Antczak added. “Really, we’re in the business of sick care. We wait until people are sick, and then we react, and we treat them and try to keep them well. We try to keep disease from progressing. But really if we want to become healthcare providers, we need to get further upstream. We need to look at ways to prevent disease from progressing to begin with, and that’s really where I think … AI can help us.”
Karam noted that programs focused on clinical outcomes often take longer to show ROI, which can be a challenge for a health system looking to contain costs.
“Some of the ROI analysis that we do is in lives impacted and lives saved even though we know that this is going to cost more dollars and cents up front,” he pointed out.
In addition, both he and Antczak noted, it takes a while to properly plan and develop an AI program.
“I don’t think people realize to successfully launch and do appropriate quality assurance on these models, it does take a significant amount of time,” Karam said.
It takes “about a year from ideation to starting a pilot,” he said. “And then we’ll pilot that model in one or two departments for another 4-6 months or so before rolling it out to the whole hospital. So about the minimum amount of time from ideation to implementation, even at a pilot level, is anywhere from a year to a year and a half. Which is not a fast turn-around, but there are so many checks and balances, so much with that data governance.”
And finally, the value of using AI in clinical care has to be measured against the risk. Many healthcare organizations are still trying to figure out how to use AI correctly, with the understanding that bad data or prompts can create bad outcomes—including, potentially, patient harm.
“Everyone is trying to identify where the guardrails are,” said Antczak, who notes Sanford Health used a tiered structure to identify risk in AI programs. Both he and Karam said it’s essential to balance any risky AI programs with human review. In any case where AI impacts a patient, they said, someone other than the technology has to make that final decision.
“It’s absolutely the final decision of the clinician or the nurse,” Karam said.
As general counsel for the clinical-stage biopharma company, Alex Nemiroff is guided by his experiences as the father of a child with a rare and incurable disease
When he was 36 years old, Alex Nemiroff's life changed forever.
That was the day his first son, Roger, was born with an extremely rare genetic epilepsy (SCN2A mutation) that currently has no cure. Roger started having seizures within hours of his birth, and he was diagnosed with a condition that carries every symptom imaginable and most often leads to death.
"He was our first child, so we really had no idea what to expect and certainly never expected this," Nemiroff says. "It was completely terrifying."
That was nine years ago. Within six months of Roger's birth, Nemiroff, an attorney, and his wife committed themselves to finding a treatment. At first, they focused only on learning enough to try to improve Roger's life.
"Doing the research was a knee-jerk reaction," says Nemiroff, now general counsel at Praxis Precision Medicines. "I thought learning more about the condition might open up some opportunity to potentially change my son's health trajectory. In retrospect, it is clear that we were trying to find a ‘fix’ so that we and our son would not have to deal with the realities of how sick he was."
With no experience in drug development, the lawyer-turned-biopharma-entrepreneur ventured out on a mission that he admits was way over his head, but he wasn’t deterred. Along with learning all he could about Roger’s condition, he began raising money and cofounded RogCon, a biotechnology company, to develop an antisense oligonucleotide to treat it.
Alex Nemiroff, general counsel for Praxis Precision Medicines. Photo courtesy Praxis Precision Medicines.
RogCon forged several partnerships on its way to developing a proof of concept. Then it enlisted the help of Praxis Precision Medicines.
"What was actually really helpful was the fact that we had no idea how challenging this was," Nemiroff says. “Throughout this process, people kept telling us we weren't going to be able to do this. ‘Go home and take care of your kids,’ they said. ‘They're very sick and need you at home. You're not going to cure this disease in their lifetime.’ But we continued to push, and here we are."
Nemiroff also began embracing spirituality, which included a deep, introspective dive into his own fears and insecurities. By creating grace, he says, he began functioning at a more wide-ranging, compassionate level, including maintaining a broader mindset around all children who are born with SCN2A.
"I really started to work on myself and to face a lot of the fears, issues and insecurities that have plagued me my entire life,” he says. “And for me, that meant diving into psychoanalysis and spirituality. What I discovered is that what holds so many of us back, whether it's being a leader, being a part of a team, driving a program, or a company, are our own issues. And so when I look back at the past with my son, I see so many things that held us up, that slowed progress down, and the way I dealt with challenges could have been a lot better. I have become more effective than ever before in confronting challenges through the personal work that I've been doing to transform these issues."
Nemiroff credits his shift in mindset to the successes along the road to development.
"Looking back, I realize how unlikely it was to end up where we ended up," he says.
“What I learned is that for any endeavor to succeed over the long term, you have to have a true, genuine, almost pure desire that is motivating and driving whatever you're doing so that it can really withstand all the attacks, challenges, and anything else that comes up along the way. I think about a time when this drug program started to slow down and get stalled, and it was incredibly frustrating and heartbreaking. It was around that time that I started to realize that trying to help my son is actually a very selfish desire. And I started to refocus my thoughts on the bigger picture, on how this will help all these other kids, and that's when things started to move."
"I was very worried about being seen as the parent of a sick child who was pushing this drug as fast as possible, and who has no appreciation for risk or drug development,” he says.
According to Nemiroff, Praxis President and CEO Marcio Souza disagreed, and he encouraged Nemiroff to be authentic.
"Your perspective is the strongest thing that you bring to the table,” Nemiroff says he was told. “You absolutely should push the urgency that you feel because otherwise, nobody is going to do it.”
“That completely changed my perspective, and transformed the way I looked at my role,” says Nemiroff, who now encourages parents and patients to speak up and add their perspective wherever they can.
“My role at the Praxis table goes beyond just general counsel, but also includes being a parent of a sick child, which informs my perspective,” he says. “And it really allows me to participate in discussions about things like drug development, science, and engaging with patients in a way I otherwise would not have been able to do. And what’s so fascinating to me is the interaction really spurs very interesting conversations and angles to look at these drugs and programs in a very different way.”
Collecting topline results of PRAX-628 in a Phase 2a PPR study in the first quarter of 2024;
The expected initiation of the Phase 2b study in focal epilepsy;
Releasing results of the Phase 2 EMBOLD study of PRAX-562 in SCN2A and SCN8A developmental epilepsies, which should be available in the first half of 2024.
Collecting topline results for both Phase 3 studies evaluating ulixacaltamide in essential tremor later in 2024;
Completing regulatory interactions to advance elsunersen (PRAX-222) towards a pivotal study for the treatment of SCN2A gain-of-function (GOF) developmental epilepsies.
Late last year, Praxis posted a preliminary analysis of PRAX-222 Part 1 that showed 44% median reduction in seizures after three doses for SCN2A-gain-of-function pediatric patients.
Designed as a safety study only, the results were a surprise and a win.
“What we saw was completely shocking and incredible to us,” Nemiroff says. “If we had had even just 10% to 15% efficacy, just to demonstrate there’s a signal, that would have been phenomenal. To see 45% median seizure reduction and a significant increase in the number of seizure free days for these kids was just incredible for us to see.”
While these statistics are beyond expectations, Nemiroff has learned to be cautiously optimistic.
“There’s been so many setbacks and challenges along the way that, sure, a fear of the other shoe dropping builds up," he says. "Until this drug is really over the line and available for all these kids, it's going to be hard to actually let go, breathe and celebrate."
CNOs must have a strike contingency plan, according to this CNE.
On this week’s episode of HL Shorts, we hear from Chaudron Carter, Executive Vice President and Chief Nurse Executive at Temple Health, about how CNOs can develop a plan for continuing operations in the event of a nursing strike. Tune in to hear her insights.
Would you recommend having a plan in place for dealing with potential strike activity?
Any organization that's embarking on a contract negotiation should have a contingency operations plan.
Most organizations that are unionized know what it is, and it is based on, “If there is a strike, how can you continue operations?” That [includes] dietary, housekeeping, radiology, and how we continue to operate as normal, or [with] some resemblance as normal, when the nurses go out on strike. [That could involve] hiring an agency to bring in a contingency workforce.
The plan is huge because nursing touches all aspects of an organization, and so you have to think of the most minute things to the larger scale items. Instead of having five Med Surg units, how can you collate them into two or three, and what areas can you downsize in to continue to still provide the same quality of care to the patients that are coming in your doors.
So that contingency plan is an operations plan that mitigates any issues around continuing operations as it relates to a strike.
The Los Angeles health system has launched XAIA, an AI-enhanced VR app designed for use with the new Apple Vision Pro headset
A health system pioneer in the use of AR and VR technology is launching a new VR app for mental health—to be used with the new Apple Vision Pro headset.
Cedars-Sinai, which has been using AR and VR for several years for a variety of treatments, last week unveiled the XAIA (eXtended-reality Artificially Intelligent Ally) app, giving users what the Los Angeles-based health system calls an “immersive therapy session led by a trained digital avatar, programmed to simulate a human therapist.”
Healthcare organizations have long experimented with AR and VR in areas like labor and delivery, pain management, pediatric care, neurological care (including concussion diagnosis and treatment), and behavioral health. The form factor holds promise for both inpatient and home use, and as an educational tool as well as a clinical tool.
“Apple Vision Pro offers a gateway into Xaia’s world of immersive, interactive behavioral health support—making strides that I can only describe as a quantum leap beyond previous technologies,” XAIA co-founder Brennan Spiegel, MD, MSHS, a professor of medicine, director of health services research at Cedars-Sinai and a pioneer in researching and using the technology, said in a press release. “With XAIA and the stunning display in Apple Vision Pro, we are able to leverage every pixel of that remarkable resolution and the full spectrum of vivid colors to craft a form of immersive therapy that’s engaging and deeply personal.”
Cedars-Sinai’s strategy here is to connect its new app with Apple’s latest consumer-facing technology, marrying consumer marketing with clinical use cases. XAIA was created by Spiegel and Omer Liran, MD, a psychiatrist at Cedars-Sinai, and is licensed by the health system for commercial sale through a spinoff company created by Spiegel and Liran called VRx Health.
The app is designed to take the user into a “spatial environment,” such as a beach or meadow, where an AI-enhanced avatar programmed to simulate a human therapist guides the user through a variety of treatments, including meditation and deep breathing exercises.
Last year, Spiegel and his team tested XAIA on 14 patients living with moderate anxiety or depression. The results of the study, published in the online journal Nature, indicated patients “described the digital avatar as empathic, understanding, and conducive to a therapeutic alliance.” Though some still preferred a human therapist.
“Virtual reality (VR) employs spatial computing to create meaningful psychological experiences, promoting a sense of presence,” Spiegel and his team explained in the study’s abstract. “VR’s versatility enables users to experience serene natural settings or meditative landscapes, supporting treatments for conditions like anxiety and depression when integrated with cognitive behavioral therapy (CBT). However, personalizing CBT in VR remains a challenge, historically relying on real-time therapist interaction or pre-scripted content.”
“Advancements in artificial intelligence (AI), particularly Large Language Models (LLMs), provide an opportunity to enhance VR’s therapeutic potential,” they added. “These models can simulate naturalistic conversations, paving the way for AI-driven digital therapists.”
The research is still a work in progress, and the researchers said the app should be used to augment human counselors rather than replace them. The study noted that XAIA sometimes questioned a patient too much, as a less experienced therapist might do, or reverted to explaining coping mechanisms rather than further probing why a patient was struggling. In addition, the app also occasionally recommended a treatment without going into detail on why it would work.
“These results provide initial evidence that VR and AI therapy has the potential to provide automated mental health support within immersive environments,” Spiegel said in a separate press release supporting the study. “By harnessing the potential of technology in an evidence-based and safe manner, we can build a more accessible mental healthcare system.”
“The prevalence of mental health disorders is rising, yet there is a shortage of psychotherapists and a shortage of access for lower income, rural communities,” he said. “While this technology is not intended to replace psychologists—but rather augment them—we created XAIA with access in mind, ensuring the technology can provide meaningful mental health support across communities.”
HealthLeaders Innovation and Technology Editor Eric Wicklund talks with Harvey Castro, MD, a physician, author, consultant, and serial entrepreneur, about the rapid development and adoption of generative AI in healthcare.
A healthy work environment is crucial to building a sustainable health system.
What is a healthy work environment?
A large part of nurse dissatisfaction involves working in poor conditions. Nurses are overworked because of staffing shortages, they’re exhausted by heavy workloads, and they’re often dealing with workplace violence and other external disruptors.
A healthy work environment is necessary for nurses to thrive, and for patients to get the highest quality care and experience when visiting a health system. Here’s how CNOs can create better conditions for their nurses.
Characteristics
Healthy work environments exist when several conditions are met, according to Deana Sievert, Chief Nursing Officer at Ohio State Wexner University and Ross Heart Hospitals. First and foremost, nurses need to be challenged to practice at the top of their licensure.
“When we talk about having meaningful, purposeful work that [nurses] need [to] have a healthy work environment,” Sievert says, “I think being able to practice at top of licensure is one of those key things.”
Nurses also need to feel like their voices are respected and heard as part of the team, and not just on the front lines, she says. Respect needs to come from the top, in the C-Suite and the board rooms, all the way to the bottom.
Shared governance models are also critical.
“That has to be saturated throughout the organization,” Sievert says, “simply because of the impact that [nurses] have on patient care, and the volume of [nurses] that exist in organizations.”
Additionally, healthy work environments have clear and proportional escalation pathways that equip nurses to solve problems. This could apply to patient care or to concerns with recruitment or competitive wages. Sievert also points out that high team engagement is critical, and can help staff approach issues in a healthier way.
“I think an engaged team is really the key,” she says. “If they’re not engaged, I don’t think that it’s even an option to have a healthy work environment.”
AACN standards
The American Association of Critical-Care Nurses (AACN) has outlined six essential standards that provide evidence-based guidelines for nurses to be successful. They are:
Skilled communication
True collaboration
Effective decision making
Appropriate staffing
Meaningful recognition
Authentic leadership
The AACN believes that healthy work environments are those in which these six guidelines are fully integrated and are helping to create “effective and sustainable outcomes for both patients and nurses,” According to Vicki Good, Chief Clinical Officer at the AACN.
“They’re all equally important and they all interrelate,” she says, “so you can’t have one without having the others present.”
From the CNO perspective, Sievert says she is pleased with the AACN guidelines, and that the organization has done a good job adding meaning behind each standard and outlining how to accomplish them.
“I think honestly our colleagues at the AACN have done an amazing job of really trying to capture those buckets,” Sievert says, “and that’s a task to capture the parts of a healthy work environment.”
Sievert says there is an opportunity for the AACN to amplify concerns with nurse well-being and self-care at work, not just when they go home.
“I think we could do a better job at incorporating [self-care] into the day-to-day work environment,” she says.
Sievert thinks the AACN should also focus on workplace violence.
“I know we’re all really struggling with [workplace violence],” Sievert says, “and I think that it would be great if we call that out maybe a little bit more.”
Outcomes
A healthy work environment offers many benefits to nurses. Such an environment improves recruitment, retention, and patient care, and there are less safety incidents.
“I think the literature is strong on this,” Sievert says. “The research shows that [hospital acquired conditions] improve.”
Good agrees, stating that the research shows the impact of healthy work environments on maintaining staff and patient outcomes.
“The evidence is clear that having a healthy work environment is [a] cornerstone to nurse well-being and retention,” Good says, “but now the research even demonstrates [the impact on] our patients.”
There are intangible benefits as well. Nurses and patients feel safer, and there is a stronger connection between leadership and nurses. Sievert emphasizes that in her career, she’s had a much stronger connection with her frontline teams, and vice versa, in healthier work environments.
“That whole body of teamwork really connects and moves things forward,” she says. “It makes all of our jobs easier [when] you’ve got that bidirectional flow of communication.”
Good concurs, citing that patient outcomes improve, there is less nurse turnover, burnout and moral distress decrease, and both the perception and actual quality of care improve.
“Not only does the perception of quality of care go up,” Good says, “[but] the actual quality of care goes up when you have a healthy work environment.”
Solutions
So how can CNOs create healthy work environments?
It starts with being the voice for the nurses, Sievert states. CNOs and CNEs represent nurses during meetings every day, in front of directors and managers in the boardroom.
“It’s definitely about being their voice because they don’t get that opportunity,” Sievert says, “and they rely upon that CNO [or] CNE role to be that voice.”
CNOs need to be able to represent nurses in the right way. This means being aware of the issues they face on a daily basis, and staying connected with nurses to understand what they need. Leaders must also be able to communicate feedback from those board meetings to the frontlines, and keep their teams posted with current updates.
“I think [it’s important to make sure] that you close that loop,” Sievert says, “because otherwise, I think our staff lose faith in regard to what we’re actually advocating for and what we’re working on.”
Good believes that CNOs should be role models for creating healthy work environments, and specifically for good communication, collaboration, and effective decision making. Leaders should also mentor nurses and ensure that they are fundamentally involved in decision making and establishing the framework for a healthy work environment.
“[CNOs] have to foster the visibility and enthusiasm for establishing a healthy work environment,” Good says.
Good also recommends building the AACN standards into performance management systems for nursing staff, so that healthy work environment behaviors become the expectation. To further spread those principles, the AACN has created a program called the Healthy Work Environment (HWE) National Collaborative.
According to Good, the HWE National Collaborative is a mentorship and co-learning program that includes nurses, physicians, administration, and ancillary services all working together to build healthy work environments. The two-year program launches in April 2024, and will be in 45 hospitals across the country.
“We will provide coaches, guidance, educational sessions, and mentor sessions to encourage and help the teams problem solve,” Good says, “and [to find out] what the biggest issues they need to solve for are in their work environment to improve it.”
Good says this kind of work is unprecedented on a national level.
“The national studies have shown us that the work environment has got to be improved,” Good says, “but there’s not a global approach to it.”
The program will cover many topics, and the AACN expects to see positive outcomes in recruitment and retention, staff and patient satisfaction, and workplace violence prevention. Good says the goal is also to disseminate research on why focusing on the work environment is going to impact all of those issues, and to teach organizations how pull together teams to work towards a common goal.
Lastly, Good hopes the collaborative will teach health systems how to implement healthy work environment standards.
“They’ve been out there for almost 20 years,” Good says, “[and] we’ve continued to struggle in how we disseminate them and operationalize them.”
To learn more about the HWE National Collaborative, visit the program page here.
