Leadership Learning Collaborative Conference Call Summary

September 10, 2013

Moderator:

Eileene Shake, DNP, RN, NEA-BC, Senior Strategic Policy Advisor to the Center to Champion Nursing in America (CCNA)

Presenters:

Chris Golding, MSN, RN, Director of Nursing Practice and Education at the North Carolina Nurses Association Leadership Institute

Denise Daly Konrad, MS, Program Officer at the Richmond Memorial Health Foundation and Director of the Foundation’s Nurse Leadership Institute in Virginia

Ellen Linkenhoker, MSN, RN, CNML, Director of Clinical Education at LewisGale Hospital Montgomery and the Health System Magnet Coordinator

Veronica Taylor, BSN, MS, Director of Professional Development, Infection Prevention and Disaster Preparedness at Campbell County Memorial Hospital

Goals of the Call: To share three states’ experiences in developing and implementing nursing

leadership institutes and programs To discuss lessons learned

Call Summary: Eileene Shake welcomed listeners and opened the discussion to representatives from North Carolina, Wyoming, and Virginia to share their experiences and lessons learned in building nursing leadership programs.

North Carolina Chris Golding, the Director of Nursing Practice and Education for the North Carolina Nurses Association (NCNA), said that NCNA is developing emerging nurse leaders through the NCNA Leadership Academy. Golding discussed the origins of the academy, the vision, the cost, the number of applicants, the programs, and the lessons learned.

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How the NCNA Leadership Academy Started

Soon after the Institute of Medicine’s report, the Future of Nursing, Leading Change Advancing Health, was released in 2010, NCNA President Ernest Grant convened an NCNA Blue Ribbon Taskforce to advise the NCNA Board on key priorities for implementing the IOM report recommendations. The Blue Ribbon Taskforce’s emphasized the IOM recommendation to prepare and enable nurses to lead change and advance health.

The Vision

The vision was to create a high-intensity, competitive application leadership development program for nurse members to educate, mentor, and prepare them to serve as active leaders in positions of strategy and influence—especially as those positions would relate to the IOM report recommendations—which include state and local government boards and commissions, elected office, hospital boards, and community boards.

Applicants to the Academy

Sixteen participants were accepted into the inaugural Leadership Academy program, which began in early 2012. An additional 16 participants completed the program in the summer of 2013. NCNA is currently accepting applications for the class of 2014.

What is the Cost?

NCNA’s Leadership Academy is housed within NCNA’s charitable arm, the North Carolina Foundation for Nursing. The total cost of the Leadership Academy program is approximately $60,000. NCNA is a major funder to the leadership academy program, which includes financial contributions and substantial staff time (about $15,000). The program participants pay tuition, which covers about 25 percent of the program costs, including room and board for three class retreats. NCNA has raised about $25,000 in external contributions over the last two and a half years, primarily from local health systems.

The Program, Leadership Academy Connections, and Projects

Nurses participate in three class retreats, which centered on:

Leadership of self, analyzing emotional intelligence, identifying strengths and opportunities for individual growth and development in the different dimensions of leadership

How to lead teams and promote and enhance team relations and communication

How to recognize and prepare for Board/community service opportunities, how to work on delivering a message, engaging in public relations and the media and participating in nursing and healthcare advocacy.

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In addition, NCNA paired class participants with two experienced leaders or mentors, one of whom was a nurse. Finally, the program grouped participants into small teams to work on projects outside of class retreats that focus on areas related to nursing advocacy, policy, education, practice and diversity. Evaluating and Measuring Outcomes

Since completing the program, NCNA reconvened the inaugural class on multiple occasions to discuss progress made toward goals that graduates set for themselves and to identify ways NCNA can continue to support graduates.

Three graduates now serve on hospital boards and/or hospital committees that report to the full hospital board. In addition, several other graduates have been elected or appointed to other association leadership board positions at the state and national levels, including the National Association of Pediatric Nurse Practitioners, North Carolina School and Community Health Association, NC State Rep of the American Academy of Nurse Practitioners. Finally, numerous other graduates have been appointed to various advisory boards, the UNC Sheps Center, Operation Medicine Cabinet, and NC Safe Kids.

Program Changes

The “leadership of self” curriculum was shortened to allow for more time, attention, and discussion related to new opportunities for extending leadership development, roles, and experiences to a broader context. The curriculum also now includes information related to Boundary-Spanning Leadership to give academy participants a perspective on how they can create direction, alignment, and commitment across boundaries to achieve an even higher vision or goal.

In the future, NCNA aims to recruit volunteer leaders to maintain ongoing relationships with the graduates and help graduates consider and foster other opportunities to serve and lead in a variety of positions. NCNA is also exploring other ways we can offer leadership development programs that are less time-intensive as it was difficult for some participants to take six days off from work to participate in three class retreats.

Golding offered some insights into nursing leadership development programs:

Self-reflection/analysis is not always comfortable or natural—but is critically important. It is important to stay true to who you are and remain open-minded to suggestions in order to uncover untapped potential, dreams and aspirations.

Stepping outside of one’s comfort zone is so critical in order for nurses to fully maximize their ability to influence decisions that will better the profession and the public.

It is important to think about ways to develop and implement leadership skills in a broader context—beyond current workplaces/roles.

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It is important to have a voice in professional associations and seek common goals/outcomes.

It is important to be surrounded by people who have different or better skill sets, expertise or knowledge. It is very important to find colleagues inside and outside the profession who know how to encourage and support us but also challenge us to think and broaden our perspective.

Wyoming

Veronica Taylor shared that the Wyoming Nurse Leadership Institute (WNLI) was developed by the Wyoming Nurses Association and is a mentorship and leadership program that focuses on experienced and emerging nurse leaders.

History and Program Development

The WNLI was developed in response to the IOM report with a $10,000 grant from the Wyoming Center for Nurses and Healthcare Partnership (WCNHCP). WNA nurse leaders developed the key concepts and presented the content at four face-to-face sessions. The key concepts included leadership concepts, personal growth, personality styles, AONE executive and nurse manager competencies, quality improvement, legislative issues, regulatory issues, and educational advancement of nurses. Each participant is assigned a mentor. They develop a project from their work environment and learn the value of networking. The first WNLI was in 2008 and 2009.

Participants

WNA and WCNHCP formed a partnership to implement WNLI. From 2009 to 2013, 43 nurses participated in WNLI. One session was held to develop long term care leaders in nursing with eight participants.

Evaluation

The Workforce grant and RWJ PIN grants allowed the institute to evaluate all the projects. Participants and employers were surveyed; variables, including leadership roles in the facility, were analyzed; and results demonstrated participants’ high value in the projects and overall success of the institute.

Sustainability

With grant funding the two coordinators of the project were able to develop the program and include LEO – Leading an Empowered Organization, a program from Creative Health Care management. A team of presenters, WNA board members, and WCNHCP board members are meeting to discuss sustainability. The plan is to continue WNLI through registration fees, contributions from health care facilities, and grants.

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WNLI has tried to supplement the four sessions with online platform of learning. However, participants did not utilize this resource well. WNLI coordinators are planning on using a teleconference format this year to assist with connectedness and networking. The mentoring piece has worked well for some participants who took advantage of experienced leaders’ accessibility. However, some did not connect at all.

Virginia

Denise Konrad of the Richmond Memorial Health Foundation said the mission of the Nurse Leadership Institute (NLI) of Virginia, a Foundation program, is to inspire, teach, and empower nurse managers and emerging nurse leaders who want to grow as leaders and become catalysts for change.

The Institute’s History and Funding

The NLI was created in 2005 in collaboration with nurse leaders from across the state to address the nursing workforce shortage by improving recruitment and retention of nurses. Initial funding was from foundations, including Richmond Memorial Health Foundation (RMHF), a two-year matching grant from the Robert Wood Johnson/Northwest Health Foundations’ Partners Investing in Nursing’s Future Program and other local foundations. Since the program’s inception, RMHF has committed more than $1 million to the NLI.

Applicants

There are 176 Institute alumni from the and 34 Fellows will be begin the NLI on September 19, 2013. Approximately 85 percent of Fellows and Alumni work in typical hospital settings; they have two to five years of leadership/management experience and, on average, 30 to 50 direct reports. About 75 percent of the 30 faculty in the program are volunteers. Fellows can earn 90 continuing education contact hours or three graduate credits.

Cost/Tuition

It costs approximately $7,600 per Fellow to operate NLI. Tuition is $2,800 with $300 paid by the employee and $2,500 paid by the employer. Four organizations provide scholarships – Virginia Nurses Foundation, Virginia Health Care Foundation, Virginia Health Care Association and Southside Health Education Foundation.

The Program

The nine-month program supports development of critical competencies, including the ability to demonstrate effective communication and relationship skills, understand the broader health care environment, understand and execute strategy effectively, manage resources efficiently, and demonstrate professionalism. There are six face-to-face retreats, an evidence-based Change Project, a structured Preceptorship and limited distance learning.

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Evaluation

Evaluation is a critical component of the program, and is conducted by a 3rd party evaluator. The evaluation model measures stakeholder satisfaction, impact, and return on community investment. Data is used to document impact of NLI activities, strengthen NLI, and justify future investments in NLI.

LewisGale Montgomery Hospital’s Experience HCA LewisGale Hospital Montgomery has participated in the program for more than 5 years. To date, LewisGale 11 nurses have participated in the Institute. Of those who have participated, all are still working in the organization and have received or are eligible to receive promotional advancement.

Projects

Evidence-based projects are selected by each fellow with input from the leadership team, including the CNO. Examples of projects completed by LewisGale Montgomery Hospital Fellows include two Fellows who identified the need to educate the community about the risk of shaken baby syndrome, and actually implemented a community-wide educational program to increase awareness and to offer solutions to avoid the stressful situations that often lead to these devastating injuries. In the past year, one of our NLI Fellows expanded her selected project to a formal research question and study that resulted in better care for our obstetric population.

Questions

Winifred Quinn, Director of Legislation and Field Operations at CCNA, asked the presenters if diversity was a priority in any of the leadership models they had discussed. She pointed out that the Campaign has a goal to increase diversity in race, ethnicity and gender within all the pillars. Chris Golding of North Carolina said diversity was an excellent factor to consider and that it should be the topic in future discussions.

There was also some concern that online learning in leadership institutes had not been embraced by nurses. Virginia Taylor of Wyoming said they thought online webinars would be ideal given the geography of Wyoming, “We found that people didn’t use it.” But they haven’t given up. Wyoming is still considering how to make presentations more inviting for the participants. Robin, who works at the University of Virginia Health System and is a graduate student said that while she does better in a face to face situation, everyone is different. Maybe it takes a combination of types of media to make instruction useful.

For more information from CCNA about this teleconference, technical assistance or other questions related to the Future of Nursing, Campaign for Action contact Michael

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Pheulpin at MPheulpin@aarp.org or 202-434-3882 or Andrew Bianco at abianco@aarp.org.

Next Steps:

The next scheduled teleconferences for the Leadership Collaborative are October 8 and November 12.

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