It used to be (not that long ago) that the majority of our nurse leadership discussions, and much of our nursing literature, revolved around hospitals. When we talked about subjects as diverse as nursing care models, patient care units, productivity, career ladders, health care payment systems, nursing education clinical sites, and even evidence-based practices, we most often referred to these subjects in the context of inpatient facilities and the outpatient sites that were connected to them. While some of us have long specialized in home health, long-term care, public health, clinic, and other types of nursing management, the primary site for the clinical leadership of our profession was assumed to be the hospital ... and, in most cases, a singular hospital. That's not so true anymore and will become less so as health care evolves.
Today, more nurse leaders are leading within health care systems. In some cases, their responsibilities include oversight of the practice of nursing across the continuum. In others, they may have management accountability for a particular service line that extends across a variety of facilities (or nonfacilities, as we move into a more virtual world). Hospitals are complex, but these new systems are even more multifaceted, which means that leaders must not only be adaptable but also be prepared to depend on others for their specialized expertise-even more than we do today.
Nurse executives and managers will continue to need proficiency in the competencies of our specialty, sometimes referred to as Management 101 (technical knowledge along with an understanding of management theory and best practices). These individuals (who may or may not have ever held an acute care management position) will also need an enhanced affinity for shared governance; an appreciation for the talents of others; a deference to others' expertise; and a penchant for teamwork, collaboration, and partnership.
Nurses have a reputation for being pretty good at teamwork, collaboration, and partnership. Even so, as health care companies grow in size and complexity, we will need to become more skilled at all three. A series of articles in this edition share experiences from colleagues who are working on reducing silos within their own systems. The authors and their associates have realized that our profession, our organizations, our communities, our employees, and, most of all, those we care for will all benefit when disparate parts of the organization coordinate their activities for the betterment of all.
I hope these articles will elicit thoughts about how you might be able to expand the work alliances and cooperation within your own systems. Improved connections will not only increase the potential for superior value (higher quality and lower costs) in your current organization but also help prepare you for even greater success in the rapidly approaching future.
Thanks for choosing to lead,
-Kathleen D. Sanford, DBA, RN, FACHE, FAAN
Editor-in-Chief
Nursing Administration Quarterly