In the second of a two-part series, CNOs talk about their plans for collaboration in the coming year
Editor’s note: This is part 2 of a two-part series. Part 1 was published on Thursday, November 30.
2024 will be restorative, if CNOs have their say.
Amid geopolitical conflict, financial headwinds, and ramped nursing shortages and unrest, there's a lot of healing that needs to happen. Starting with the healers.
“The current times have required a new level of operational rigor [and] a keen focus on the people providing the care and service,” says Kate FitzPatrick, DNP, RN, NEA-BC, FAAN, executive vice president and Connelly Foundation chief nurse executive officer at Jefferson Health, which has 17 hospitals throughout New Jersey and Pennsylvania.
To set the stage for success in 2024 and beyond, CNOs must build up their teams, both in number and resilience, nurse execs and experts tell HealthLeaders. That means making compensation compelling, fostering shared purpose, redesigning care models, and playing a very long game when it comes to recruiting.
And while buoying wellbeing for beleaguered teams may sometimes seem at odds with imperatives like driving quality care and efficiency, it's the right strategy, says Jeff Doucette, DNP, RN, NEA-BC, FACHE, FAAN, chief nursing officer at Press Ganey, which provides experience survey solutions and consulting services to healthcare organizations, including nursing leaders and teams.
“What our data clearly shows is that if you are not taking an employee-first approach right now, you will never be able to meet the … patient promises that organizations are making to their communities,” he says.
Here are some more ways that CNOs are approaching teamwork in 2024:
Another key to cultivating a rich and rewarding professional environment: Giving nurses a say in the strategy.
“I've been really fortunate to be in an organization that’s supported shared governance my entire career,” says Meredith Foxx, MSN, MBA, APRN, NEA-BC, PCNS-BC, PPCNP-BC, CPON, executive chief nursing officer for Cleveland Clinic. That includes getting input from every nursing council on “policy changes, practice changes, even the conversations around virtual nursing.”
Just be sure to define a clear scope so nurses aren’t asked to solve problems outside their purview, Foxx advises.
“Keeping them within track of what they can focus on, what should be their priorities,” she says.
Cleveland Clinic also invites nurses to shape innovation through formal opportunities like its annual Shared Governance Day, which Foxx launched in 2006 to give team members the chance to present their research and ideas to colleagues. Many go on to present at national conferences, and some even see their work enshrined as best practice across the enterprise. This year, nurses submitted more than 100 poster presentations.
“That’s just a testament to their engagement around wanting to be involved and wanting to solve the problems,” Foxx says.
The health system also invests heavily in professional development for their nurse managers.
“They have one of the hardest, if not the hardest, jobs in health systems,” Foxx says. “And so how do we continue to support them, make those jobs meaningful, and also develop that level of leader and then encourage other folks to want to be those leaders?”
In part, it’s by enhancing nurse manager onboarding with residencies and fellowships that offer formal programs for learning, development, and progression, including a homespun portfolio process that allows nurse managers to showcase their work and impact.
Take a lifelong lens to recruiting
Designing the care team of tomorrow means filling holes both current and anticipated.
“Everyone is going to be competing for the same resources and staff so it will be important to capture the staff as early as possible and to provide them a look into what it can be like to work in an exceptional organization,” says Deana Sievert, DNP, MSN, RN, chief nursing officer at The Ohio State University Wexner Medical Center.
Organizations are struggling with turnover at the 1- to 3-year mark, Doucette says, and it's because they're not hiring the right people.
“We got used to doing Zoom interviews for 10 minutes during the pandemic,” he says. It's not the right format and not nearly enough time to get how someone might gel with the team or what they need to feel supported and included.
Instead, he recommends spending up to three hours on the interview process, and building in conversation with the hiring manager, a structured peer interview, and an immersive experience on the unit or team.
“All of those things drive high sense of belonging and put employees at a much higher engagement level and at lower risk of leaving the organization,” he says.
Jefferson has implemented some of these practices with creative flair. FitzPatrick's team partnered with the college of nursing to launch a capstone program that provides seniors a three-week immersive experience in a desired unit. It also allows nursing leaders to find and offer employment to promising new team members before they even graduate.
Cleveland Clinic starts cultivating their workforce young, offering high schoolers and even grade schoolers opportunities to explore nursing through activities like shadowing, school and career fair visits, and summer programming.
The Howley ASPIRE Nurse Scholars program is its crown jewel. About to enter its eighth year, the program provides local tenth graders a 12-week career intensive and ongoing support throughout their high school and college careers. Beyond drumming up early interest in what Foxx calls an “incredible career choice,” the program aims to increase diversity in the nursing profession and reduce health and opportunity disparities by accepting 50 students annually who are poised to be first-generation college students, have a financial need, and/or come from a community that nursing has historically marginalized.
It’s working. To date, Cleveland Clinic employs five ASPIRE graduates and has clinched funding to formalize its early grade recruitment efforts into the Center for Nurse Exploration in early 2024.
It’ll allow the system “to follow those students and possibly look at other ways to support them,” including through wraparound services and “rich data and analytics” to do more of what works, Foxx explains.
Nurse executives are just as interested in talent on the other side of the career spectrum.
“We have lost a segment of our healthcare workforce due to retirement,” FitzPatrick says. To help recoup some of that “experience and intellectual brain trust,” they've debuted the Jefferson Nurse Emeritus Program, which brings back retired nurses to provide mentoring, direct care, and patient support.
Keep patients at the heart
Patients also feature prominently in 2024 plans.
“Everyone expects high quality patient care,” Foxx says. “The patients and families expect that, and expect a holistic experience with that care.”
FitzPatrick shares this focus. In the year ahead she's continuing to prioritize health equity, including in the realms of screening and intervention.
“Be knowledgeable about the social determinants of health that are important to those you are serving and align strategies accordingly.”
Nursing teams can help drive success with large-scale initiatives.
“Position nurses to lead in population health work and service line work,” FitzPatrick says. “Their line of sight and connection to patients and families will enrich this work.”
Her team plans to engage both groups in the new year by introducing a care partner model that allows patients to identify the person who will support them in their hospital journey and make key decisions together to “authentically advance” care.
Other priorities include educating patients on evolving strains of COVID-19 and expanding access and efficiency through telehealth without sacrificing connection.
“Technology-enabled care will continue to be an important component of care delivery,” FitzPatrick says. “And we will need to assure we don't lose the humanity of the care experience with this.”
Delaney Rebernik is a contributing writer for HealthLeaders.
“[Nurses] have one of the hardest, if not the hardest, jobs in health systems. And so how do we continue to support them, make those jobs meaningful, and also develop that level of leader and then encourage other folks to want to be those leaders?”
— Meredith Foxx, MSN, MBA, APRN, NEA-BC, PCNS-BC, CPON, executive chief nursing officer, Cleveland Clinic
From economic downturn to staffing upheaval, nursing executives are up against some dogged forces heading into 2024.
To set the stage for success, CNOs must build up their teams both in number and resilience, nursing chiefs and experts say.
How? Make compensation compelling, share purpose and power, redesign care for the future, and play a very long game when it comes to recruiting.