Role of the Clinical Nurse Leader - PowerPoint PPT Presentation

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Role of the Clinical Nurse Leader

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Competency levels of new graduates. UPMC HEALTH SYSTEM. Emergence of the PNCC role ... Demonstrated competency as an expert clinician. Demonstrated leadership ... – PowerPoint PPT presentation

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Title: Role of the Clinical Nurse Leader


1
UPMC HEALTH SYSTEM
  • Role of the Clinical Nurse Leader
  • Experience from the field

2
University of Pittsburgh Health System
  • Integrated health care delivery system
  • 20 hospitals ranging from an academic medical
    center to small rural hospitals
  • 35,000 employees
  • 6000 nurses

3
A Case for Change Major Driving Forces
  • Patient demand exceeding nursing supply
  • More complex, high risk patients who require
    exquisite nursing expertise
  • Need for improved continuity across the continuum
    of care
  • Numerous broken systems that require clinical
    leadership and intervention
  • Competency levels of new graduates

4
Emergence of the PNCC role
  • Based on our Professional Practice Model
    (Transformational Model)
  • BSN or above required
  • 3-5 years experience
  • Demonstrated competency as an expert clinician
  • Demonstrated leadership skills

Manager
PNCC
Staff
5
Requisite behavioral skills
  • Ability to plan and organize
  • Ability to mentor and develop others
  • Adaptability
  • Good analytical skills
  • Good interpersonal skills
  • Good communication skills
  • Initiative
  • Strong customer service orientation
  • Tolerance for stress
  • Conflict management skills

6
Role of the PNCC
  • Manages a case load of 15-20 patients
  • Facilitates the assessment, planning,
    interventions and evaluation of patient care
  • Facilitates the smooth coordination of care
    across the continuum
  • Ensures that clinical resources are utilized in
    the most effective manner
  • Evaluates issues, trends, etc. within the patient
    population
  • Serves as an expert clinical resource to members
    of the health care team

7
Outcomes
  • Less fragmentation of patient care
  • Significant decrease in length of stay
  • Improved patient satisfaction
  • Improved physician satisfaction
  • Nurses enjoy the role minimal turnover or
    vacancies

8
Educational Development
  • Basic leadership skills
  • Planning and decision making
  • Communication skills
  • Improving staff performance
  • Coaching staff
  • Conflict resolution
  • Delegation
  • Creating a service culture
  • Innovation and change
  • Time management
  • Basic healthcare economics

9
Next stepsEvolution of the Role
  • In smaller community hospitals, Advanced Practice
    Nurses have been utilized in this role and also
    serve as physician extenders
  • Recently pilot tested merging the PNCC role and
    the Case Manager role into a Primary Care
    Coordinator role with good results.
  • Plans to implement the role in home care and long
    term care facilities

10
Lessons learned
  • Can work in all different types of organizations,
    but looks a little different in each
  • Flexibility is key
  • People revert to what they know (e.g. charge
    nurse)
  • This is a different role that must be constantly
    reinforced
  • The organizational sell is both clinical and
    financial
  • Partnering with the medical staff
  • Budgeting at least some non-direct time

11
CNL Issues to be addressed
  • What level of preparation will be required?
  • How do we develop this level of expertise
    without actual clinical experience beyond a
    student experience?
  • How can we merge academics and the real world
    that this role will encounter?
  • How can we integrate our advanced nurses and
    faculty? Can we learn from the medical model?
  • What can we eliminate from the curriculum in
    order to add the requisite leadership skills
    necessary for this role?
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