Developing and Sustaining Nursing Leadership NHS Nursing Strategic Plan A Blueprint for Nursing

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Developing and Sustaining Nursing Leadership
NHS Nursing Strategic Plan A Blueprint for
Nursing
RNAO Creating Health Work Environments Summer
Institute August 12, 2008 Presented by Donna
Rothwell, Interim CNE VP Patient Services The
Niagara Health System A RNAO Best Practice
Spotlight Organization
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The Niagara Health System A RNAO Best Practice
Spotlight Organization since 2006
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Introduction

• Promoting healthy workplace encouraging
  leadership at all levels within nursing is
  paramount in todays health care environment
• Healthy work environments play a critical role in
  ensuring job satisfaction, quality safe client
  care sustainability of our health care system

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Achieving Healthy Work Environments

• Requires transformational change with
  interventions that target underlying workplace
  organizational factors
• By promoting transformational leadership
  practices encouraging leadership at all
  levels, nurses feel engaged supported in their
  work environment
• Engaged nurses feedback their energy enthusiasm
  into the organization further creating a healthy
  work environment, improved organizational
  performance enhancing clinical outcomes, ct
  satisfaction

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Why Now?

• Nursing is a practice profession made up of
  knowledge workers
• Competitiveness
• Existing and evolving nursing shortage
• Competitiveness
• Consistent feedback from nursing staff in all
  forums for professional practice support
• Competitiveness

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What Does the Evidence Say?

• A Magnet Hospital study reported three primary
  objectives
• to identify excellence in the delivery of
  nursing services to patients/clients, to promote
  quality in a milieu that supports professional
  nursing practice, and to provide a mechanism for
  the dissemination of best practices.
• Holtz et al, An invitation to Magnet
  Accreditation Trying to Garner this coveted
  distinction? Nursing Management. (2004).

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• We need to
• focus on those skill sets required for nurses
  today and tomorrow. We need to teach learn new
  patient care information technologies, leading
  working in interdisciplinary teams, ability to
  research health care trends, apply understand
  statistical data relevant to practice, and
  continuous lifelong learning in professional
  practice.
• Michael Villeneuve, Towards 2020 Visions for
  Nursing C N A (2006)

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• Indicators that influence the quality of
  nurses work life are staff mix ratios,
  educational background of nursing staff,
  experience of nursing staff, team functioning,
  organizational climate and culture, span of
  control for clinical manager, workload and
  productivity, level of autonomy and
  decision-making experienced by nurses,
  professional development opportunities, scope of
  nursing leadership role, overtime and absenteeism
  hours.
• Linda McGillis Hall Quality Work Environment
  for Nurse Patient Safety 2005

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Healthy Work life Best Practice Initiative
(2005-2007)

• In collaboration with West Park Healthcare
  Centre, the NHS, Saint Elizabeth Health Care
  VON Canada we formed a partnership to work
  collaboratively with RNAO to systematically pilot
  the implementation evaluation of the RNAO
  Healthy Workplace Environment BPG Developing
  Sustaining Nursing Leadership

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NHS Environmental Scan

• Patient Care Service Reviews 2003-2007 conducted
  by QWL
• Relations by Objectives a joint endeavor with
  NHS ONA
• Employee Feedback Survey 2005

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NHS Environmental Scan Results

• Need for more leadership on nursing units,
  improvements in working relationships improved
  communication
• Opportunities for professional development
• Quality of work and home life balance
• EFS showed lack of trust in leadership, need to
  involve nurses in decision making, need for more
  effective communication opportunity for
  professional development

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Results Aligned with Transformational Leadership
Attributes

• Transformation leadership attributes outlined in
  the RNAO BPG Developing Sustaining Nursing
  Leadership were essential for our Clinical
  Managers and Permanent Charge Nurses within the
  NHS

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NHS Approaches to Developing Sustaining
Nursing Leadership

• 1st strategy focused on leadership development
  through education for our 95 Permanent Charge
  Nurses across the NHS
• A 2-day educational session was provided for
  them our Clinical Managers focusing on the core
  competencies related to transformational
  leadership in the BPG

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NHS Approaches to Developing Sustaining
Nursing Leadership

• Monthly Nursing Leadership meetings held with
  Interim CNE, Health Program Directors Clinical
  Managers embedded the BPG as the framework for
  our meetings
• Each month a presentation is done from any
  Program and/or individual on Professional
  Nursing Practice
• Following the presentation we have dialogue
  debate to link the essence of the presentation to
  the transformational leadership elements within
  the BPG

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NHS Approaches to Developing Sustaining
Nursing Leadership

• These presentations reinforced the importance of
  leadership provided professional development
  time for self-reflection
• This year we began to have two extraordinary
  Nursing Leadership meetings in collaboration with
  our Permanent Charge Nurses to build on
  transformational leadership practices
• NHS has revised all position descriptions to
  incorporate the competencies associated with
  transformational leadership for the PCN

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NHS Integrates Developing Sustaining Nursing
Leadership BPG

• A number of factors supported this initiative
• It is aligned with the NHSs vision, mission
  values
• It is aligned with the NHS Nursing Strategic
  Plan A Blueprint for Nursing

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VISION
C COMPASSION
Patient/Client Centered Care
P PROFESSIONALISM
Collaborative practice

professional accountability
R RESPECT
Therapeutic client professional relationships
Philosophy Statement
Conceptual Framework for Professional Practice
Model of Care
Service Delivery Model
Service Delivery Model
Service Delivery Model
Service Delivery Model
DIRECTIONAL NURSING WORK PLAN
Developed by Tracy MacDonald, CNE/VP Patient
Services Donna Rothwell,
CNO/PPO/HPD
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• Evolved a Nursing Strategic Plan - A
  Blueprint for Nursing (2006-2009)

• Created a Nursing Vision, Philosophy
  Conceptual Framework for Professional Nursing
  Practice 2006/2007

• Engaged all nursing leaders in strategic planning
  2006

• Engaged all Nursing
• Leaders in this strategic planning process in
  2006 including front line staff nurse focus
  groups across seven sites

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Ensuring full scope of practice for RN (EC)s,
RNs, RPNs further refinement for RNs 2008
Adopted RNAO BPG Developing Sustaining Nursing
Leadership as our framework for leadership
completed the HWI 2005-2007
Secured funding for Nursing Demonstration Site
Initiative Nursing Human Resources in
progress ED Baseline Staffing

• Engaged all nursing leaders in strategic planning
  2006

Secured funding for IMPLC (2007) implementation
of inter professional mentorship program
resulting in increased numbers of mentors to
support novice nurses now ICEF 2008/2009

• New Graduate Guarantee Late Career Nurse
  Initiative

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White paper developed tabled with Senior
Executive on Professional Nursing Practice
Two RNAO Advanced Clinical Practice Fellowships
2007 Completed
Launched Patient Client Centered Care within the
NHS

• Engaged all nursing leaders in strategic planning
  2006

Approved ACLS/PALS funds for Critical Care staff
Initiated Nursing Grand Rounds focused on
clinical professional practice
Journal Clubs NPDC Nursing Leadership
Secured funds to explore Inter professional
Practice within the NHS ICEF
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Conceptual Framework for Professional Nursing
Practice
Healthy Work Environment
Organizational Supports
Communication Systems
Standards of Practice
Competence
Model of Care

• Therapeutic Professional Relationship

Therapeutic Professional Relationship
Therapeutic Professional Relationship
Healthy Work Environment
Healthy Work Environment
Advocacy
Evidence Based Practice
Inspiring leadership excellence in
Nursing through living the values sharing the
knowledge. Prepared for the present.
Challenging the future.
Innovation Research
Patient Safety Initiatives

Response to External Demands
Therapeutic Nurse Client Relationship
Care Delivery Process
Patient/Client Centered Care
Coaching Mentoring
Therapeutic Nurse Client Relationship
Collaborative Practice
COMPASSION Patient/Client Centered
Care PROFESSIONALISM Collaborative Practice
Professional
Accountability RESPECT Therapeutic
Client
Professional
Relationships
Leadership
Critical Thinking Decision Making
Ethics
Therapeutic Professional Relationship
Therapeutic Professional Relationship
Healthy Work Environment
Healthy Work Environment
Facility, Equipment Technology
Continuous Professional Development
Empowerment Autonomy
Monitoring Evaluating
LEGEND
Quality Practice Setting Attributes
November 2006 Revised May 31, 2007 TM/DR
Nursing Attributes
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What is Nursing Doing in the NHS in Response to
this Evidence?
White Papers
Phase 1 Enhancing Professional Nursing Practice
Phase 2 QWL Baseline Staffing
Phase 3 Leadership Infrastructure Support
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Key Themes Embedded in Our Nursing Strategy- A
Blueprint for Nursing

• Enhanced professional practice and leadership
  development Developing Sustaining Nursing
  Leadership RNAO BPG as our framework
• Enhanced quality and safe patient care- initiated
  our 6th theme Patient Safety 2008- Transfer of
  Accountability and Prevention of Falls
• Refined the NHS Nursing infrastructure- NPPAC and
  NPDC
• Creating a supportive work environment to enhance
  quality of work life (QWL)

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Redesigning the Nursing Professional Practice
Model (2006) Enhancing Nursing Leadership

• RN RPN - Co-Chairs Claudia Danyluk, RN and
  Carol McDowell, RPN
• Professional Practice Model that supports
  leadership, accountability, autonomy and
  collaboration
• Enhancing nursing leadership at all levels
• Maximize scope of practice and enhanced
  competencies for RNs, RPNs and RN (EC)s
• Values the contributions of all categories of
  nurses
• Recognizing and sharing nursing expertise
  knowledge
• Shared planning and decision making
• Open communication dialogue about nursing
  practice

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Sustaining Nursing Leadership

• Monthly Interim CNE Reports are shared and
  discussed at NPPAC, NPDC, IPAC MAC
• Monthly Interim CNE Reports are shared and
  discussed at the Senior Team Board of Trustees
  meetings monthly
• First Annual Nursing Report launched during
  Nursing Week May 2008- highlighting nursing
  leaders throughout the NHS
• Poster Presentations at RNAO NLN 2007 2008
• RPNAO 50th Anniversary- Claudia/Carol presented
  on NPPAC at their Nursing Conference

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Our Nursing Leadership Journey Continues

• Professional Practice
• Review refine RNAOs BPGs- Pain Assessment
  Falls Prevention
• RNAO Advanced Clinical Practice Fellowships
• Nursing Inter professional Grand Rounds monthly
  
• Developing Sustaining Nursing Leadership
• Further education in leadership development for
  nurses throughout the NHS utilizing Developing
  Sustaining Nursing Leadership BPG
• PCN Workshops April 2008 September 2008
• Ongoing theme in our Nursing Strategic Plan A
  Blueprint For Nursing

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NHS Nursing Vision Statement

• Inspiring leadership and excellence in nursing
  through living the values sharing the
  knowledge. Prepared for the present challenging
  the future

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Key Points for Developing Sustaining Nursing
Leadership

• The RNAO Best Practice Guideline is grounded in
  evidence
• This guideline has served as a roadmap to our
  organization in our endeavors to build and
  support nursing leadership
• It is an excellent tool for succession planning
  for all nurses

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Key Points for Developing Sustaining Nursing
Leadership

• The NHS will continue to use this document as a
  blueprint for further leadership development
  initiatives
• Committed to providing professional development
  for our PCNs in collaboration with our Managers
  to further sustain nursing leadership
• Continue to share our experiences with other
  nursing colleagues