Jeffrey M. Adams

Applying the Adams influence model in nurse executive practice.

The ability to influence others is a required competency for nurse executives trying to achieve positive patient/organizational outcomes. The Adams Influence Model (AIM) is a framework for understanding the factors, attributes, and process of influence. The AIM is grounded in nursing and organizational literature and provides nurse leaders with a road map for developing an effective strategy to achieve influence with individuals and/or groups. The authors describe the AIM and present a case study illustrating its application by a chief nurse executive.

Identification of the psychometric properties of the leadership influence over professional practice environments scale.

This study uses the qualitatively developed Adams Influence Model© (AIM) and concepts from the psychometrically validated Revised Professional Practice Environment scale to guide the development of the Leadership Influence Over Professional Practice Environments Scale. Nurse executives and others can use this scale individually or in conjunction with instruments targeting staff or patient perceptions of their influence as part of health services research, leadership development, and professional practice environment enhancement strategy.

Applying the Model of the Interrelationship of Leadership Environments and Outcomes for Nurse Executives: A Community Hospitalʼs Exemplar in Developing Staff Nurse Engagement Through Documentation Improvement Initiatives

The Model of the Interrelationship of Leadership, Environments & Outcomes for Nurse Executives (MILE ONE) was developed on the basis of existing literature related to identifying strategies for simultaneous improvement of leadership, professional practice/work environments (PPWE), and outcomes. Through existing evidence, the MILE ONE identifies the continuous and dependent interrelationship of 3 distinct concept areas: (1) nurse executives influence PPWE, (2) PPWE influence patient and organizational outcomes, and (3) patient and organizational outcomes influence nurse executives. This article highlights the application of the MILE ONE framework to a community district hospitals clinical documentation performance improvement projects. Results suggest that the MILE ONE is a valid and useful framework yielding both anticipated and unexpected enhancements to leaders, environments, and outcomes.

Strengthening new graduate nurse residency programs in critical care: recommendations from nurse residents and organizational stakeholders.

BACKGROUND Thirty-four new graduate nurses participated in a critical care nurse residency program in preparation for opening a new intensive care unit. At the end of the program, multi-constituent focus groups were held to assess program effectiveness. METHOD Participants included 34 new graduate nurses, 18 preceptors and staff nurse partners, five clinical nurse specialists, and five nurse directors. Twelve focus groups were held; groups included four to eight nurses from the same role group. Two independent reviewers analyzed recordings and transcripts of focus group content to identify themes. RESULTS Five themes were identified: program design, developing nursing expertise, program impact on the unit, future expectations, and communication. Comments were used to guide program improvements and offer new insights for residency programs in acute and critical care. CONCLUSION Obtaining structured input from multiple program stakeholders is beneficial in evaluating a programs impact and identifying areas for improvement.

How do we know if we're innovating? Setting the strategy for innovation evaluation.

I was recently watching television, and it struck me that the word innovation was used in 7 consecutive commercials. I spent the next half hour pondering, ‘‘What is the common link between automobiles, haircuts, soda, airlines, hardwood flooring, and healthcare?’’ and ‘‘What do people mean when they say ‘innovation’?’’ Eventually, I came to the conclusion that TV commercials used innovation to convey a new idea that produces, adds, or enhances value or, in marketing language, to say ‘‘the next great thing.’’ In healthcare delivery organizations, we are uniquely challenged in that there is a real and defined need for innovation. Yes, there is a long history of innovative inventions, products, and discoveries in healthcare (ie, vaccines, medications, artificial organs, etc). But what happens when we need to innovate the structures and processes for how healthcare is delivered? The existing paradigms of care delivery have proven to be fiscally unsustainable and may not support the delivery of the safest, most effective, timely, patient-centered, equitable care. Thus, a comprehensive plan for the future must address cost reduction, but also fundamentally how care is provided. Large governing healthcare entities such as the Centers for Medicare & Medicaid Services and the American Nurses Credentialing Center’s Magnet Recognition Program identify innovation as a key component of transforming healthcare. This has driven a growing need to quantify, articulate and replicate innovation ina tightly resourced,operational care delivery setting. The experiences from the Massachusetts General Hospital Innovation Unit Program (Program) provide a unique insight into innovation in a care delivery setting and specifically evaluation of innovation. The Program was developed as a frontline initiative to address the gaps in the continuum of care and utilize the expertise of all clinical disciplines to improve the patient experience, quality of care, staff satisfaction, and empowerment while decreasing redundancy, costs, length of stay, and readmission rates. The progress and successes of this trailblazing model are in response to current and future healthcare reform stem from interventions that span philosophy,practice, technologies, and roles and also include a thorough strategy to evaluate innovation interventions in an operational setting, essentially letting us know how we are doing rebuilding the ship while it is sailing. The initial, broad approach to data collection and evaluation of this complex innovation Program utilizes multiple measures including focus groups, surveys, observations, and analysis of quality and administrative data. As this expansive approach to data collection was planned, there was a conscious effort to also prepare to support specificity in inquiry as needed. The immense amount of data were valuable, but the how, when, and what was the emerging story that needed to be clearly articulated

The influence of administrative leadership: an interview with Dr Karen S. Hill.

This department highlights nursing leaders who have demonstrated a commitment to patient care leadership and innovation in practice, policy, research, education, and theory. This interview profiles Karen Hill, DNP, RN, NEA-BC, FACHE, FAAN, chief operating officer and chief nursing officer of Baptist Health in Lexington, Kentucky, and editor-in-chief of the Journal of Nursing Administration.

Carrying Skills From One C-Suite to Another: An Interview With Dr Maureen Swick

This interview of Dr Maureen Swick chronicles career development and preparation for a transition into the role of CEO of the American Organization of Nurse Executives. While there are an estimated 400 000 nurses in middle management roles in the United States and 5700 in the most senior nursing positions in US hospitals, Dr Swick has assumed a role leading the leaders and highlights those experiences that have influenced her and provides insights into her vision for nursing leadership.

Influencing Scope of Practice Policy and Health Literacy: An Interview With Dr Joy Deupree

This department highlights emerging nursing leaders who have demonstrated leadership in advancing innovation and patient care in practice policy, research, education, and theory. This interview profiles Joy Deupree, assistant professor, School of Nursing, The University of Alabama at Birmingham.

The Influence of Emerging Leadership in Nursing: An Interview With Dr Casey Shillam

This department highlights emerging nursing leaders who have demonstrated leadership in advancing innovation and patient care in practice, policy, research, education, and theory. This interview profiles Casey Shillam, PhD, RN, associate dean for baccalaureate education, University of Portland School of Nursing, Oregon.

Exemplars of Innovation in Practice: Implications of the AONE-CIT and CMS Innovation Advisors Projects Within the Massachusetts General Hospital.

Innovation in health care requires leaders to influence the development of positive environments that accelerate innovation and produce better outcomes for patients, the workforce, and organizations. Given the multifaceted changes in todays health care system, nursing leaders must utilize opportunities for innovation to focus on enhancing practice environments. In this article, nursing leaders who oversee personnel on direct care delivery units report on how they worked within existing organizational structures to influence improvement in practice environments while accelerating innovation.