Joyce E. Johnson

Leadership in a time of disaster: Being prepared for new age threats

The attack on the Pentagon on September 11, 2001 provided a Washington, DC, healthcare institution with firsthand experience in evaluating its disaster readiness. This account of one nursing leader’s experience with the unexpected suggests that an actual disaster gives disaster planning new meaning because it challenges the entire institution and the community to maintain order in the midst of chaos. Included are practical lessons learned from this case study, guidelines for disaster planning, national disaster resources, and a vision for the role nursing leaders play in assuring patient care during times of disaster.

Succession Management: A Model for Developing Nursing Leaders

Succession management is critical to all healthcare organizations as they respond to the cost-cutting initiatives brought about by the prospective payment era. This personnel management system ensures that motivated individuals enter and ascend the management hierarchy consistently. Such stabilization is reflected in turnover vacancy rates of < 12 percent and < 9 percent, respectively, at a time of unprecedented competition for professional nurses. This provides not only greater professional advancement but also stability for patient care delivery.

Breaking the fall.

Objective: The Helping Hands program is a nurse-directed falls prevention program designed to support a hospital-wide culture of safety and reduce harm from falls. Background: Patient falls and the associated morbidity and mortality represent a significant risk for patients and healthcare facilities. Age-adjusted fatalities from falls increased significantly from 1993 to 2003. By 2020, the annual cost of injuries from falls is expected to exceed

The Benefits of a Nurse-Driven, Patient- and Family-Centered Pediatric Palliative Care Program.

40 billion. Methods: Components of the Helping Hands falls prevention program worked synergistically to support the development of a culture of safety at Robert Wood Johnson University Hospital. The program consisted of nursing assessment of fall risk with the Johns Hopkins Fall Risk Assessment Tool; reviews of fall risk and intervention efficacy; creation of communication mechanisms, reporting processes, and change champion roles; engagement of patients and families in falls prevention; increased public awareness of fall risk through signage; nursing interventions; and utilization of nursing performance improvement analysts. Results: Over 3 years, 65% (N = 7,900) of more than 12,000 patients assessed were at risk of falling. Most falls caused no or little harm, and at 3 years of follow-up, total falls decreased by 16.6 %, and severe falls accounted for 0.009 % (n = 2) of all falls. Conclusions: The data offer a hopeful perspective on the role of nursing engagement in developing a hospital-wide culture of safety and protecting patients from permanent harm caused by fall events.

Professional development for nurses: mentoring along the u-shaped curve.

This article describes the program and outcomes of a nurse driven, patient- and family-centered pediatric advanced comprehensive care team (PACCT) palliative program. This care delivery model improved patient outcomes by providing care across the healthcare continuum for pediatric patients. Since the inception of PACCT, no child has died on a ventilator in the pediatric ICU associated with end-of-life–related issues.

Cause Celebre: Georgetown University Hospital’s Journey to Magnet

Shortages of nurses are expected to continue throughout the coming decade. To meet the demand, nursing leaders must develop creative approaches for nurturing and sustaining nursing talent. Traditionally, nursing has embraced a variety of development strategies to enhance the leadership abilities of nurses and to fill the leadership ranks with top talent. We describe the rationale, design, and impact of a 3-pronged organizational approach to mentoring nursing talent at Georgetown University Hospital, the first Magnet hospital in Washington, District of Columbia. The design of these programs was driven by the demographics of our nursing staff. Analysis of length of tenure revealed a modified “U-shaped curve” with the majority of new nurses with tenure less than 5 years, few in the middle between 5 and 15 years, and a moderate number with 15 or more years. Investment in all our nurses’ leadership development required integrating a diverse developmental process into our organizational culture, which values personal growth and mastery. A strong mentoring program makes good business sense in terms of employee job satisfaction, improved cost control, and better patient outcomes. Our experience suggests that voluntary mentoring programs work synergistically to further the development of a mentoring culture in todays hospitals.

Automating a Patient Classification System: Nurse-Vendor Collaboration

Designation as a magnet organization by the American Nurses Credentialing Center is a coveted distinction for health care organizations. These organizations experience fewer problems with nurse recruitment and retention because they have been found to be good places to practice professional nursing. Better patient outcomes have also been documented in these organizations. In this article, the authors recount their 3-year experience leading an organization successfully to become the first magnet organization in the nation’s capitol. The magnet application and review process is linked to the core principles of organization development. The authors conclude with policy recommendations for other organizations that are just beginning their journey to achieving magnet status and with reflections on leadership and the value created by participating in the magnet program.

Marketing Your Nursing Product Line: Reaping the Benefits

Automation in hospital nursing departments can exert a profound impact on patient care, on the ability of nursing administration to cost-out and control services, and on the development of nursing’s professional body of knowledge (Donaho & Hess, 1984; Happ, 1983; Kiley, Halloran, Weston, Ozbolt, Werley, & Grier, 1983). Automation systems must not only meet nursing’s current information requirements but also provide flexibility to accommodate future needs. Creation of a successful system requires nursing input at each stage of activity, beginning with vendor selection and continuing through system development and training.

Nursing participation in computer vendor selection

Survival in todays cost-conscious, competitive health care scene depends on strategic business skills, marketing, and product line management. As a major contributor to the delivery of health care, nursing practice must now include an orientation toward business with definable products. The authors discuss their success in developing a product line that results in professional growth, improved nurse recruitment and retention, and a greater competitive edge in the health care arena.

From Toyota to the bedside: nurses can lead the lean way in health care reform.

Automation in hospitals has been steadily increasing since the 1980s, but only recently have clinical applications been given similar weight to the business side of the hospital industry. With the increased concentration, a tend is now developing in having the primary users of hospital information systems directly involved in the planning, development, implementation and evaluation of all facets of such systems. This involvement will produce applications which more readily meet the needs of the clinical areas than the first generation of products which were designed primarily by vendors whose experience had been with interrelating financial models.