by Debra Pollick, RN, MS
As the healthcare industry reshapes itself in response to the Affordable Care Act, nurses – the employees on the front-lines of healthcare – will be one of the most impacted groups. The most effective hospitals will employ teams of efficient, talented nurses, and in order to build teams deserving of that designation, they’ll also need to employ highly skilled and effective Chief Nursing Officers.
The Chief Nursing Officer role is a big one – one that’s changed quite a bit over the past decade. Today’s CNO needs to be prepared to tackle the following priorities:
In the 1970s and 80s the Chief Nursing Officer role was called the VP of Patient Care Services. At that time, the nursing field was composed almost exclusively of women, and the CNO was rarely included in strategy planning or major hospital decisions. The nursing group was often forced to operate in its own silo, not allowed to participate in larger discussions about hospital strategy.
Fortunately, the playing field is leveling, and CNO’s are now gaining seats at the table with other C-level executives, increasingly playing a role resembling a Chief Operating Officer. Now they must be able to think strategically about larger hospital objectives. Moreover, since more departments – radiology, laboratory, and case management, for example – fall under the CNOs span of control, s/he needs to represent those voices at the table. The CNO must be able to collaborate with other hospital departments, serve as an advocate for the teams s/he oversees, and understand how the nursing department’s performance impacts the hospital.
Talent Management and Development
The newest generation of nurses will be caring for a dramatically different type of patient. Because the Affordable Care Act makes preventative care more accessible, those patients that do need hospital care will be much sicker. The quantity of patients will decrease, but the level of care required will increase. As a result, nurses will need to focus less on productivity and more on quality of care. The CNO must be able to identify and hire highly talented nurses, but must also be able to retain those nurses and dedicate the required resources to invest in their development and continuing education.
Understanding the Economics of Healthcare
Because ACA regulations hold hospitals accountable for the quality of patient care, there are financial implications of nurses’ daily decisions. The Chief Nursing Officer must understand the long-term consequences of the services nurses provide. S/he must be able to relay the financial risks associated with poor care to her counterparts in hospital administration and strategize how to effectively mitigate those risks.
In addition to building a highly talented team, a CNO must think about developing a pool of qualified candidates to step into the CNO role. Today’s CNOs are largely in their late 50s and 60s, nearing retirement age, so succession planning should be top of mind. Additionally, many young nurses are taking specialty tracks, like informatics and nurse practitioning, so it will become increasingly important to identify nurses that are both focused on high-quality care and interested in entering a leadership position.