I recently had the chance to talk with two of the nation’s most prominent nursing leaders — Lamont M. Yoder, the CEO of Banner Gateway Medical Center and Banner MD Anderson Cancer Center in Gilbert, Ariz., and Carol Bradley, senior vice president and chief nursing officer of Legacy Health in Portland, Ore. We had a great conversation about the many different ways nurses can help hospitals navigate our changing health care landscape.
Both leaders believe passionately that the nursing skill set required for value-based care is much broader — but fortunately also more exciting — than that needed in the volume-based care of just 10 years ago. Yoder and Bradley outlined eight key skills they think will help nursing leaders tackle tomorrow’s value-based-care challenges:
Commitment to advanced education
According to Yoder, by 2020, health care will be nearing the Institute for Healthcare Improvement’s goal of 80 percent of all entry-level nurses having a bachelor’s degree. That’s great progress for the profession, but, Yoder says, “A (Bachelor of Science in nursing) is a door-opener; it’s no longer the ceiling.” For Yoder, “with the fast pace of change in today’s health care system, it’s impossible for any B.S.N. program to perfectly situate a nurse to transition from an academic setting and be fully prepared for a nursing career.” That’s why nurses need to be committed to constantly advance their education, both formally and informally. “Ten years ago, hospitals would have been thrilled to have just a few direct care nurses with graduate level education. Not anymore. The standard level of education for today’s [and tomorrow’s] nursing leaders is becoming the doctorate,” Yoder said.
Mindset of continuous learning
Nursing is a rewarding and fulfilling career, but it’s a difficult and constantly evolving job, too. Wherever nurses may be in the care continuum, they will encounter fast and near-constant change. That’s why it’s so important for nurses to develop a mindset of continuous learning. According to Yoder, that may mean finding a mentor or coach who can provide feedback based on the career path a nurse wants to pursue — especially considering that those career paths are increasingly endless. Bradley added that nurses also need to embrace new ways of learning — whether that be in role-play situations, simulation environments, participating in national initiatives or even learning from other industries. Finally, it means being comfortable with change — and committing to the kind of continuous learning that’s needed to not just keep up with but lead that change.
While lots of different forces may be changing the face of health care, few are more transformative than technology. Technology is making it possible for nurses to communicate and build relationships with patients before they enter the hospital and long after they’re discharged. It’s helping nurses share evidence-based practices, improve patient safety, drive inefficiencies out of the system and much more. In fact, there’s no facet of health care that technology is not continually shaping and transforming. That’s why Bradley asserts that it’s now more important than ever for nursing leaders to have a strong foundation in and affinity for technology.
Relationship building and collaboration
Nurses have always been collaborators and relationship builders. They’ve long been on the front lines, working more closely with patients and their families than have perhaps any other clinicians in the hospital setting. And they’ve always been focused on working with others to provide the best possible care to patients. But according to Yoder, nurses in leadership positions are increasingly being called upon to build and extend those relationship-building and collaboration skills far outside the hospital. “Nursing leaders also need to be prepared to collaborate with industry partners, community partners in pre- and post-care, technology and teleheath networks, insurance companies, and other players, to find new ways to efficiently provide quality care for populations.”
Bradley says that the transition to value-based care is also providing more opportunities for nurse leaders to play leadership roles beyond their health care systems. “There’s now a greater expectation that nursing leaders will be meaningfully involved in their communities, serving on boards, engaging with other nonprofits that serve our communities, and leading hospital and professional associations," Bradley said. "Nursing’s voice and presence in these groups is not only valued but increasingly necessary to help our communities effectively respond in meaningful ways to evolving health care challenges.”
Performance-driven business acumen
Hospitals and health systems are continually expected to deliver better outcomes to an ever-increasing number of patients while also driving down costs. “We are being measured every which way possible,” Bradley said. That’s why she says it’s critical that nursing leaders are performance-driven. “Nursing leaders need to have the business acumen to analyze the way care is being delivered and apply clinical value analyses and the kind of 'lean' thinking that can reduce waste, inefficiency and costs.”
While it’s true that nursing leaders need to be increasingly focused on driving performance and outcomes, the reality is that no single player on the health care team can do it alone. It takes broad groups of clinicians and other experts to achieve meaningful, widespread, effective change. And, according to Bradley, that kind of change requires more than simple collaboration. It requires the emotional intelligence to know how to motivate, engage, inspire and lead others toward a common goal. “In earlier decades, the people who were doing the work weren’t sufficiently involved in developing new ways to deliver care. The ability to involve and engage staff in change is essential for nurse leaders. We need to learn to lead in a way that creates results while making staff feel challenged and rewarded, not punished,” she said.
Resiliency, flexibility and adaptability
Nurses have always needed to adapt to last-minute changes, expanding workloads, and the sometimes unpredictable needs of physicians and patients alike. “Because of the rapid pace of evolutionary change that’s going on in health care, nurses need to continually strengthen and expand skills like resiliency, flexibility and adaptability," Yoder says. "We all entered into nursing to make a difference in other people’s lives. Tomorrow’s nursing leaders will be the ones who accept that the future of health care will be constantly evolving ... and are willing to be flexible to adapt to and lead that change.”
Certainly, the skills required for a successful career in nursing leadership have rapidly evolved over the past decade as we’ve moved from a volume-based to a value-based world. But for those who entered the field with a sincere interest in truly making a difference in the lives of patients, there’s never been a more exciting time for nursing leaders. Nurses who build and develop these eight skill sets are sure to be the ones who make the most meaningful and lasting impact on their facilities, their colleagues and, most of all, their patients.
Heather O’Sullivan is the chief clinical officer of naviHealth, a Cardinal Health company based in Brentwood, Tenn.