Building an Evidence-Based Foundation for Virtual Nursing.

Virtual nursing is viewed as a key strategy to support safe, effective staffing in acute care amid continued RN workforce challenges. Consensus has not been reached on the optimal model that can drive highly impactful results for virtual nursing. Research is needed on the most effective strategies to optimize the role of the virtual nurse. In addition, nurse leaders need evidence to confirm which virtual models are the most strongly positioned to impact staff and patient satisfaction, quality, labor costs, and length of stay.

Reversing the Great Resignation in Nursing: More Things to Consider.

ABSTRACT: Much has been written about the impact of COVID-19 on the US labor market, most recently described as the Great Resignation of employees in American industries. The question for healthcare executives is whether factors prompting massive resignations in other industries have any bearing on efforts to retain the healthcare workforce, particularly in nursing, and what nursing leaders can do to address this trend.

7 Executive Strategies to Stabilize the Nursing Workforce.

The COVID-19 pandemic exacerbated long-standing challenges in the workforce, resulting in a shortage of nurses that has now reached crisis levels. At the same time, there is a concerning "skills gap" that has been emerging for some time. Leaders have typically relied on legacy recruitment and retention strategies to mitigate these challenges, but these will not be sufficient to address staffing gaps. In this article, the authors discuss how current staffing challenges differ from previous workforce shortages and propose 7 executive strategies for C-suite leaders to prepare for the future nursing workforce.

Confronting the Workforce Tsunami: Nonnegotiable Tactics to Reverse the Exodus of RNs.

The sobering facts are clear: hospitals and health systems are facing a severe nursing shortage, with safe inpatient staffing approaching near-crisis levels. Safely staffing inpatient care is challenging. Stopping the exodus of nurses from acute care must be prioritized by the entire C-suite, with the chief nurse executive at the center of all decisions. Beyond aggressive retention strategies, different in-kind solutions to address the practice environment are nonnegotiable and help address nursing concerns about continued hospital employment.

The Global Pandemic: Should COVID-Inspired Care Innovations Continue?

The COVID pandemic generated unparalleled operational disruption. C-suites and chief nurse executives responded to create capacity and clinical readiness despite enormous uncertainty. Innovations were put in place to combat the care crisis; however, is there merit in continuing these innovations as the pandemic subsides? Examining highly impactful operational innovations that were rapidly implemented during the pandemic should be prioritized as organizations seek to establish their new normal.

Chief Nurse Executive Readiness for the Here and Now.

The significant role of the chief nurse executive in leading healthcare innovation has been widely discussed in the literature, including the importance of monitoring market disruptors and determining how to best respond. Critical to implementing and sustaining innovation is attention to leadership competencies, organizational enablers, and cultural transformation throughout the entire nursing enterprise. Chief nurse executives are challenged to examine personal and organizational readiness.

Next-Generation Staffing Models: Are You Ready to Innovate?

Despite Health Resources and Services Administration projecting a national excess of approximately 300 000 RNs as compared with demand by 2030, continued regional and local shortages have been confirmed. Pockets of chronic nurse shortages for various reasons, continued margin pressures, increased inpatient care complexity, continued RN turnover, and overall RN resilience are prompting chief nurse executives to investigate staffing model innovations. Next-generation staffing models include those that significantly embrace new teams and technology, as well as the philosophy of primary nursing care. Chief nurse executives must carefully analyze all models from the standpoint of organizational, cultural, and professional norms, as well their role in spearheading such efforts.

Another Look at Differentiating Nursing Practice.

Designing and improving efficient, effective staffing models remain a top priority for chief nurse executives (CNEs). However, market forces are pushing the need for staffing model innovation. Both innovative and widely debated in professional and academic circles, differentiated nursing practice has yet to be widely adopted. CNEs are challenged to revisit new realities and confront organizational, professional, and culture barriers that are impeding this staffing model innovation.

A Call to Action on Point-of-Care Violence in Hospitals and Health Systems.

Despite deeper investment in security measures, the rate of violence and point-of-care safety threats in healthcare settings is rising. As a result, nurses do not always feel safe while delivering care. In this article, the authors describe strategies for addressing point-of-care violence. This is the 2nd article of a series. The 1st article of this series, Cracks in the Foundation of the Care Environment Undermine Nurse Resilience, in the December 2018 issue (volume 48, issue 12) of The Journal of Nursing Administration, the authors explained how nursing leaders can reduce frontline nurse stress and burnout by addressing 4 "cracks in the foundation" of the care environment that can undermine nurse resilience. This article aims to help leaders address 1 of the foundational cracks: that violence and point-of-care safety threats are now commonplace in healthcare settings.

Confronting Clinical Rotations.

The pace and scope of change in the US healthcare industry has been relentless. Organizational and system responses include dramatic redesign of structures, processes, and services to support cross-continuum care. The education of nursing students must keep up with rapid delivery system change. Beyond significant curricular revision, innovation in undergraduate clinical rotations to better prepare students for cross-continuum practice will be key.

Employers as Consumers of Healthcare.

Amazon, Berkshire Hathaway, and JP Morgan Chase shocked the industry with its announcement to join forces to cut healthcare costs and improve healthcare services for its employees. This is just the latest of employer efforts to disrupt the industry by the creation of alternative healthcare delivery networks that demonstrate high-value, low-cost services as compared with what traditional provider systems have to offer. What factors are behind this industry disruption, and what are the key implications for nurse executives?

Here Comes Price Transparency.

The public reporting of clinical and operational performance measures is old news for chief nurse executives (CNEs). Since the advent of value-based purchasing and patient experience measures, CNEs have partnered with other executives to ensure organizational readiness and success with the performance measures being publicly shared. In 2018, healthcare organizations face a new wave of public reporting expectations-price. Once again, executives will need to ensure organizational readiness. Chief nurse executives must analyze the impact of this trend on the nursing enterprise and carefully consider how to best prepare for healthcare price transparency.

Consumer-Centric Care: Latest Buzzword or New Reality?

With the industry in flux as federal healthcare reform legislation debates continue, leaders are preparing for what the post-Affordable Care Act world might look like. Predictions include patients assuming more responsibility for healthcare costs and therefore behaving like consumers, including choosing providers based on perceived value. What actions should chief nurse executives take to ensure the nursing enterprise responds to rising consumerism in healthcare?

Cross-continuum Care Continuity: Achieving Seamless Care and Managing Comorbidities.

As healthcare systems continue to design care models responsive to payment changes and the assumption of clinical and financial risk, the need exists for a comprehensive approach to address cross-continuum care transitions. This article will highlight key learnings from the Nurse Executive Center's research on achieving care continuity. The business case for developing a cross-continuum care transition strategy will be discussed, as well as systemic enablers for the achievement of seamless care. A case study example of 1 system's solution for supporting the multiple comorbid patient population as part of its cross-continuum care transition strategy will be examined.

The Bundled Care Disruption.

The new administration and Congress will wrestle with the Affordable Care Act and options. In the meantime, several reimbursement programs designed to disrupt current approaches to patient care delivery continue, including the Centers for Medicare & Medicaid Services bundled payment program. Chief nurse executives must prepare to advance processes and care models that align with bundled payments and the broader ambition to eliminate care variation.

The Explosion of Virtual Nursing Care.

The call for care model innovation is clear, spearheaded by rising healthcare costs, changing payer expectations, overall fiscal and workforce shortages, and an increasingly comorbid patient population requiring significant, long-term support. As part of care model innovation, the leveraging of technology is key.

Translating Market Forces Into Frontline Terms.

To transform healthcare delivery, frontline nursing staff must be committed to their work and to driving their organization's mission forward. However, Advisory Board Survey Solutions data show that nurses are the least engaged as compared with other frontline staff. In this article, the authors identify a top opportunity for improving nurse engagement: ensuring that nurses understand how executives' actions reflect their organization's missions and values.

Nurse Executives Wearing 2 Hats as Strategic Leaders.

Disruptions in healthcare are challenging nurse leaders to develop innovative care delivery strategies and make the space for nursing practice innovation at the point of care or service. These functions are interdependent and require strong nursing leadership to challenge the status quo thinking of our colleagues. The ultimate goal of disruptive innovation is to ensure that care innovations are aligned with changing consumer and payer expectations, while ensuring safety, reliability, and cost-effectiveness.

Providing Professionally Meaningful Recognition to Enhance Frontline Engagement.

To achieve transformation in care delivery, frontline nursing staff must be committed to their organization's mission, engaged in their work, and capable of delivering high-quality care. However, data from Advisory Board Survey Solutions show that, when compared with other frontline staff, nurses are the least engaged and most disengaged. In this article, the authors describe strategies for addressing a top opportunity for improving nurse engagement-ensuring nurses feel meaningfully recognized for their professional impact.