Transformational Leadership Introduction

8/2/2019 Transformational Leadership Introduction

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TransformationalTransformational

Leadership Council (TLC)Leadership Council (TLC)

Creating a Culture of ChangeCreating a Culture of Change

Sustaining a Culture of SafetySustaining a Culture of Safety


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Sea of OpportunitiesSea of Opportunities

So much to doso little timeSo much to doso little time

What can we do to make a sustainableWhat can we do to make a sustainable

difference? How can we do it?difference? How can we do it? Patient and family centered carePatient and family centered care

Work environment, culture of safetyWork environment, culture of safety

Innovations and improvements to promoteInnovations and improvements to promoteexemplary professional practiceexemplary professional practice

Teamwork is essential for moving forwardTeamwork is essential for moving forward


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Transformational LeadersTransformational Leaders

Inspire the team commitment needed to manifestInspire the team commitment needed to manifestthe vision of the future in realitythe vision of the future in reality

Are creative change agents who take everyAre creative change agents who take every

opportunity to develop othersopportunity to develop others


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Transformational LeadershipTransformational Leadership

Transformational Leadership meansTransformational Leadership means collectivecollectiveempowerment:empowerment:

All parties work together to achieve a shared goal.All parties work together to achieve a shared goal.

Focus is innovation and change.

Focus is innovation and change.

Followers have a sense of mission.Followers have a sense of mission.

Leaders inspire followers beyond interpersonalLeaders inspire followers beyond interpersonalrelationships and extrinsic rewards for a job well done.relationships and extrinsic rewards for a job well done.

People have a purpose: worthwhile, meaningful and

People have a purpose: worthwhile, meaningful andimportantimportant..

Anderson, S. & Miller, A. (2007). Implementing Transformational Leadership as a Modelfor Service Learning Activities in an Online RN to BSN Leadership Course. OnlineJournal of Nursing Informatics (OJNI), 11, (1).


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Transformational LeadersTransformational Leaders

Nurses are responsible for providingNurses are responsible for providing high qualityhigh qualitypatient care in a culture of safety.patient care in a culture of safety.

Transformational leaders help achieve this goal Transformational leaders help achieve this goal

Make the experience meaningful, inspiring,Make the experience meaningful, inspiring,

excitingexciting Appeal to our sense of mission and purpose ofAppeal to our sense of mission and purpose of

making a difference in peoples livesmaking a difference in peoples lives

Manage well in an environmentManage well in an environmentof constant changeof constant change

Anderson, S. & Miller, A. (2007). Implementing Transformational Leadership as aModel for Service Learning Activities in an Online RN to BSN Leadership Course.Online Journal of Nursing Informatics (OJNI), 11, (1).


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Who are theWho are the

Transformational Leaders?Transformational Leaders? WE ALL ARE!WE ALL ARE!

Clinical practitionersClinical practitioners

Clinical Nurse SpecialistsClinical Nurse Specialists Nurse and Patient EducatorsNurse and Patient Educators

Nurse ManagersNurse Managers

Directors, ViceDirectors, Vice--Presidents, the CNOPresidents, the CNO

Care ManagersCare Managers Patient Safety and QualityPatient Safety and Quality

Nurses in nonNurses in non--traditional, nontraditional, non--direct care rolesdirect care roles

WEAREWEARECOLLECTIVELY EMPOWEREDCOLLECTIVELY EMPOWERED TO BELEADERSTO BELEADERSW

HEREVER

WE

PRA

CTI

CEW

HEREVER

WE

PRA

CTI

CE


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Nurse ManagerNurse Manager

Nurse EducatorNurse Educator Exemplary PracticeExemplary PracticeRepresentativeRepresentative

ChangeChange


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The New Magnet ModelThe New Magnet Model


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Transforming Our PracticeTransforming Our Practice

Building a culture of changeBuilding a culture of change

Transformational leaders will help to buildTransformational leaders will help to build

exemplary professional practice at the unit levelexemplary professional practice at the unit level Our Transformational Leadership Councils roleOur Transformational Leadership Councils role

will evolve to reflect the roles defined by thewill evolve to reflect the roles defined by theNew Magnet ModelNew Magnet Model

Initially, the Council will provide the foundationalInitially, the Council will provide the foundationalstructure needed to build all other councilsstructure needed to build all other councils


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Transformational LeadershipTransformational Leadership

Council RolesCouncil Roles Advocacy and InfluenceAdvocacy and Influence

Visibility, Accessibility and CommunicationVisibility, Accessibility and Communication

Strategic PlanningStrategic Planning


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Advocacy and InfluenceAdvocacy and Influence

Assist the CNO with organization wide changesAssist the CNO with organization wide changes

Guide the transition during periods of changeGuide the transition during periods of change

Oversee leadership development, performanceOversee leadership development, performancemanagement, mentoring and the successionmanagement, mentoring and the successionplanning for all nurse leadersplanning for all nurse leaders

Support nurse leaders in valuing, encouraging,Support nurse leaders in valuing, encouraging,

rewarding/recognizing and implementingrewarding/recognizing and implementinginnovations.innovations.

EO: Providing evidence of one CNOEO: Providing evidence of one CNO--influencedinfluencedorganization wide changeorganization wide change


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Visibility, Accessibility andVisibility, Accessibility and

CommunicationCommunication Solicit input from staff nurses on how to improveSolicit input from staff nurses on how to improve

the work environment and patient carethe work environment and patient care

Assist the CNO with visibility and accessibility toAssist the CNO with visibility and accessibility todirect care nursesdirect care nurses

Establish methods for staff nurses to access allEstablish methods for staff nurses to access allnurse leadersnurse leaders

EO: Doing all of the aboveEO: Doing all of the above


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Strategic PlanningStrategic Planning

Align nursings mission, vision, values,Align nursings mission, vision, values,strategic and quality plans with hospitalstrategic and quality plans with hospital

plansplans Provide mechanisms for all nurses toProvide mechanisms for all nurses to

advocate for resourcesadvocate for resources

Help improve the health systemsHelp improve the health systemseffectiveness and efficiencyeffectiveness and efficiency

EO: Reflects weve done all of the aboveEO: Reflects weve done all of the above


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Initial Role ofInitial Role ofOurOur TransformationalTransformational

Leadership Council (Part 1)Leadership Council (Part 1) Provide active leadership in establishing:Provide active leadership in establishing:

1) Unit Based Exemplary Professional Practice1) Unit Based Exemplary Professional PracticeCouncilsCouncils2) Exemplary Professional Practice Oversight2) Exemplary Professional Practice OversightCouncilCouncil

Address global nursing issues, problems,Address global nursing issues, problems,policies, procedures until the councilpolicies, procedures until the council

transformations are complete.transformations are complete. Meetings: Monthly for 2 hours until theMeetings: Monthly for 2 hours until the

end of the year; time to be determinedend of the year; time to be determinedby the groupby the group


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Initial Role ofInitial Role ofOurOur TransformationalTransformational

Leadership Council (Part 2)Leadership Council (Part 2) Serve as the leaders to help develop andServe as the leaders to help develop and

establish the other councils NKII, SE,establish the other councils NKII, SE,

and the EO Congressand the EO Congress Final stepFinal step: The council will evolve to: The council will evolve to

adapt the role of Transformationaladapt the role of Transformational

Leadership Council from the MagnetLeadership Council from the Magnetmodel and move forward in that capacity.model and move forward in that capacity.This probably wont mature until 2010This probably wont mature until 2010


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Creating A Culture of ChangeCreating A Culture of Change

Getting Outcomes Oriented!Getting Outcomes Oriented!

Moving from tasks to goalsMoving from tasks to goals

Confucius Say: Where there is device,Confucius Say: Where there is device,there is larger purpose.there is larger purpose.

Getting in tune with the NationalGetting in tune with the NationalInitiatives related to quality and finance

Initiatives related to quality and finance

Investigating the science underlying allInvestigating the science underlying allregulatory and payer requirementsregulatory and payer requirements


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Changing How We ChangeChanging How We Change

Increasing the autonomy of each unit forIncreasing the autonomy of each unit forinitiating changes in their practicesinitiating changes in their practices

Identifying what works, what doesnt

Identifying what works, what doesnt

May be clinical, educational, operationalMay be clinical, educational, operational

Changes will be created, implemented andChanges will be created, implemented andmonitored at the unit levelmonitored at the unit level

Results of unit based exemplary practice willResults of unit based exemplary practice willeventually be presented at the Exemplaryeventually be presented at the ExemplaryProfessional Practice Oversight Council: theProfessional Practice Oversight Council: theforum for sharing successes and opportunitiesforum for sharing successes and opportunities


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Nurse ManagerNurse Manager

Nurse EducatorNurse Educator Exemplary PracticeExemplary PracticeRepresentativeRepresentative

ChangeChange


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UnitLeadership Triads: Facilitate UnitUnitLeadership Triads: Facilitate Unit

Exemplary Professional PracticeExemplary Professional Practice

Nurse ManagerNurse Manager:: Overseer of operations andOverseer of operations andacquisition of resourcesacquisition of resources

Nurse EducatorNurse Educator:: Overseer ofOverseer of Credentials andCredentials andnew knowledgenew knowledge

Exemplary Professional Practice CoordinatorExemplary Professional Practice Coordinator::Overseer of work teams; Chairperson of theOverseer of work teams; Chairperson of the

unit based practice committeeunit based practice committee

The triad works together to establish workThe triad works together to establish workteams and ensures all are able to move forwardteams and ensures all are able to move forward

effectively on the defined performance goalseffectively on the defined performance goals


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Focus on OutcomesFocus on Outcomes

Patient OutcomesPatient Outcomes

MortalityMortality

HealthcareHealthcare--acquired infectionsacquired infections

Falls with injuriesFalls with injuries

Hospital acquired pressure ulcer incidence andHospital acquired pressure ulcer incidence andprevalenceprevalence

Patient satisfactionPatient satisfaction Patient Perception of SafetyPatient Perception of Safety

Specialty Population Specific: MI, CHF, CAP,Specialty Population Specific: MI, CHF, CAP,Surgical (SCIP)Surgical (SCIP)


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Nurse OutcomesNurse Outcomes

Professional commitment/engagementProfessional commitment/engagement

Nurse satisfaction: Healthy work environmentNurse satisfaction: Healthy work environment

Turnover and vacancy rates:Turnover and vacancy rates:Retention/recruitmentRetention/recruitment

Percentage of certified direct care RNs andPercentage of certified direct care RNs andleadersleaders

Educational preparation of staffEducational preparation of staff

Rates/types of all staff injuriesRates/types of all staff injuries

Staff perception of autonomy, safe culture, workStaff perception of autonomy, safe culture, workenvironment, orientation and effectiveness ofenvironment, orientation and effectiveness of

continuing educationcontinuing education


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Consumer OutcomesConsumer Outcomes

Impact of community outreach programsImpact of community outreach programs

Community health and welfareCommunity health and welfare


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Organizational OutcomesOrganizational Outcomes

Efficiency and elimination of wasteEfficiency and elimination of waste

Chief nursing officer (CNO) impact onChief nursing officer (CNO) impact on

system level changesystem level change


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UnitTriads Establish Work Teams ForUnitTriads Establish Work Teams ForAreas in Need of ChangeAreas in Need of Change

Plan, Implement and Evaluate the units:Plan, Implement and Evaluate the units:

Professional Practice ModelProfessional Practice Model (Unit Based(Unit BasedCouncil, made up of work team chairs and keyCouncil, made up of work team chairs and key

individuals)individuals) Care Delivery SystemsCare Delivery Systems (Team Nursing)(Team Nursing)

Staffing, Scheduling and Budgeting ProcessesStaffing, Scheduling and Budgeting Processes(Triad plans resources needed for daily staffing(Triad plans resources needed for daily staffingand work teams)and work teams)

Interdisciplinary CareInterdisciplinary Care (MAP and Orders(MAP and Ordersdevelopment)development)


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UnitTriads Establish Work Teams ForUnitTriads Establish Work Teams ForA

reas in Need of ChangeA

reas in Need of Change Accountability, Competence, AutonomyAccountability, Competence, Autonomy

(Appropriate credentialing for knowledge needed for(Appropriate credentialing for knowledge needed forindependent decision making)independent decision making)

Quality Care Monitoring and ImprovementQuality Care Monitoring and Improvement (Patient(PatientSatisfaction)Satisfaction)

Culture of SafetyCulture of Safety (ACT initiatives, Patient Safety Goals,(ACT initiatives, Patient Safety Goals,Smooth MovesSmooth Moves

Ethics, Privacy, Security, and ConfidentialityEthics, Privacy, Security, and Confidentiality(HIPAA, CIA)(HIPAA, CIA)

Diversity and Workplace AdvocacyDiversity and Workplace Advocacy (Disruptive(Disruptivebehavior)behavior)


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Choose Projects which can produceChoose Projects which can produce

measureable outcomes quicklymeasureable outcomes quickly Will not be prescriptive, but all units shouldWill not be prescriptive, but all units should

review ACT data if its reported to you, and havereview ACT data if its reported to you, and havechampions in placechampions in place

IfACT initiatives are not a problem, they do notIfACT initiatives are not a problem, they do notneed action plansneed action plans

Consider MAP development, patient satisfaction,Consider MAP development, patient satisfaction,Soarian documentation building, unit specificSoarian documentation building, unit specificproblems, butproblems, but

Make sure all hospital wide and national PIMake sure all hospital wide and national PIinitiatives (NQF) are on your radar screen!initiatives (NQF) are on your radar screen!


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Lets TransformFor the good of ourLets TransformFor the good of ourpatients and ourselvespatients and ourselves

Transformational leadership at all levels of theTransformational leadership at all levels of theorganization (from COO to the staff nurse)organization (from COO to the staff nurse)

Transforming Care at the Bedside (TCAB)Transforming Care at the Bedside (TCAB)

Safe and Reliable CareSafe and Reliable Care: Innovative, constantly: Innovative, constantlyimproving, incorporating new knowledgeimproving, incorporating new knowledge

Vitality and TeamworkVitality and Teamwork: A supportive environment: A supportive environmentstructured to empower nurses to develop professionallystructured to empower nurses to develop professionally(Nurse Satisfaction)(Nurse Satisfaction)

Patient Centered CarePatient Centered Care: Exemplary Practice of: Exemplary Practice ofCollaborative Care (Patient Satisfaction)Collaborative Care (Patient Satisfaction)

Value Added CareValue Added Care: Eliminate waste, promote: Eliminate waste, promotecontinuous flow (Balancing quality and finance)continuous flow (Balancing quality and finance)


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TCAB Nationally: Outcomes of UnitTCAB Nationally: Outcomes of UnitDriven ChangeDriven Change

Participants emphasize: Change in unit culture

Engagement of front-line staff in improvement

activitiesCreating this change has also resulted in: Complementary changes in the culture: Increased

Sharing and Collaboration Between Units

View of quality/performance improvement: Sensible

changes with increased buy in Leadership at the hospital level

Transformation is an expectation inMagnet Hospital


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Exemplary Professional PracticeExemplary Professional Practice

Oversight Council (EPC)Oversight Council (EPC) All unit based Exemplary Professional PracticeAll unit based Exemplary Professional Practice

coordinators will attend to report on work teamscoordinators will attend to report on work teams(performance improvement)(performance improvement)

Division Practice Committee chairpersons reportDivision Practice Committee chairpersons reporton policy development and approvalon policy development and approval

May be a new forum for interdisciplinary andMay be a new forum for interdisciplinary andhouse wide policies review and approvalhouse wide policies review and approval

Membership may include: Ethicist, otherMembership may include: Ethicist, otherprofessional disciplines, support services, careprofessional disciplines, support services, caremanagement and patient safety and qualitymanagement and patient safety and quality


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Kim Sharkey: TransformationalKim Sharkey: Transformational

Leadership FacilitatorLeadership Facilitator

Marianne Baird:Marianne Baird:Structural EmpowermentStructural Empowerment

FacilitatorFacilitator

Karen Zorn: ExemplaryKaren Zorn: ExemplaryProfessional PracticeProfessional Practice

FacilitatorFacilitator

New Knowledge,New Knowledge,

Innovations andInnovations and

ImprovementsImprovements


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Team STEPPS: Leadership ModelTeam STEPPS: Leadership Model

Program sponsored by the US DepartmentProgram sponsored by the US DepartmentofDefenseofDefense

Building shift based patient care teamsBuilding shift based patient care teams

Establishing unit leadership structureEstablishing unit leadership structure

Building problem focused work teamsBuilding problem focused work teams

Communication and team workCommunication and team work


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Our Iceberg is MeltingOur Iceberg is Melting

The Iceberg Manifesto:The Iceberg Manifesto: The amountThe amountof required change will only increaseof required change will only increase

We need to create a heightenedWe need to create a heightenedsense of urgency nowsense of urgency now http://www.leadingboldchange.com/prework/ Demo/indehttp://www.leadingboldchange.com/prework/ Demo/inde

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Do you feel like a nomad?Do you feel like a nomad?

Nomad: NOUN: 1. A member of a group ofNomad: NOUN: 1. A member of a group ofpeople who have no fixed home and movepeople who have no fixed home and move

according to the seasons from place toaccording to the seasons from place toplace in search of food, water, and grazingplace in search of food, water, and grazingland. nomadic, nomadically, nomadismland. nomadic, nomadically, nomadism

Transformational Leadership Introduction

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