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Description
The healthcare system is plagued with increasing cost and poor quality outcomes. A major contributing factor for these issues is that outdated leadership practices, such as leader-centricity, linear thinking, and poor readiness for innovation, are being used in healthcare organizations. Through a qualitative case study analysis of innovation implementation, a new framework of leadership was uncovered. This framework presented new characteristics of leaders that led to the successful implementation of an innovation. Characteristics uncovered included boundary spanning, risk taking, visioning, leveraging opportunity, adaptation, coordination of information flow, and facilitation. These characteristics describe how leaders throughout the system were able to influence information flow, relationships, connections, and organizational context to implement innovation.
ContributorsWeberg, Daniel Robert (Author) / Fluery, Julie (Thesis advisor) / Malloch, Kathy (Thesis advisor) / Porter-O'Grady, Timothy (Committee member) / Hagler, Debra (Committee member) / Arizona State University (Publisher)
Created2013
Description
Nurses are ideally positioned to lead the transformation of healthcare delivery in the United States, however they must be prepared to do so. The Institute of Medicine has called for nurses to become change agents and assume leadership positions across all levels in order to become full partners with physicians and other health care providers. While clinical leadership is a responsibility for all nurses, expectations for new nurse clinical leadership have not been well studied.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
ContributorsMiehl, Nickolaus (Author) / Komnenich, Pauline (Thesis advisor) / Hagler, Debra (Thesis advisor) / Lamb, Gerri (Committee member) / Arizona State University (Publisher)
Created2018