BOUNDARY SPANNING LEADERSHIP
Health care systems are rapidly expanding their market share, increasing in size, complexity, and interdependence through mergers and acquisitions. As organizations grow, boundaries are created. The boundaries could present roadblocks and bottlenecks, or they could represent opportunities to create innovative solutions for managing health.1,2 Boundaries can be created by demographic, vertical, horizontal, geographical, or stakeholder characteristics of organizations. Boundary spanning leadership supports knowledge workers as they coordinate and collaborate their efforts across boundaries by creating direction, alignment, and commitment across organizational boundaries. In other words, boundary spanning leadership builds bridges to facilitate coordination and collaboration across boundaries. Effective boundary spanning leadership is exhibited in 3 ways. The first strategy is the ability to differentiate boundaries to clarify specialization and roles. The second strategy is to forge common ground. Finding common purpose fosters trust among entities. The third strategy is to discover new frontiers that support transformation and innovation.
In no other time has the US health care system had to innovate as quickly or expansively as in the past year. One of the outcomes of leading organizational responses to the COVID-19 pandemic has been a stronger appreciation for boundary spanning leadership practices. In this issue, Dr Bonnie Jennings shares her keynote address to members at the 2020 International Meeting of the Association for Leadership Science in Nursing. Through her address, Dr Jennings traces the historical roots, evolution, and future directions of current practices in leadership science. In her address, Dr Jennings reminds us that the current health care system expansion is not new; rather, it is an amplification of past health care system redesign. The lesson nurse leaders must remember and build on from the past is the negative impact of this environmental turbulence on nurses' work environments and resulting job dissatisfaction for nurses. Dr Joyce Fitzpatrick presents the value of narrative nursing as a technique to elicit lessons learned from 4 national nursing leaders. Narrative nursing represents a strategy nurse leaders might use to build resilience in our nursing workforce that is needed now more than ever.
Also in this issue, Caramanica and O'Rourke illustrate the boundary spanning leadership principles as community leaders created a seamless network to manage the long-term care needs of COVID-19 patients. The rapid expansion of health care systems challenges nurse executives to rethink and innovate their traditional professional practice models. Mislan, Johnson, and Keitel describe how they lead the development of a network-level professional practice model as an organizational structure to support nursing as they navigate the complexities and boundaries of a matrixed organization. Important conceptual work is introduced to nursing by Brandford and Brandford-Stevenson as they present a look at the elevation of men in nursing leadership roles.
The evidence demonstrates that financial competencies are the least well-developed for nurse leaders.3 With this issue, we are launching a new feature: Finance Matters in Nursing Leadership! This column will feature an article in each issue to help strengthen finance-related competencies of nurse leaders. In our inaugural column, Drs Todd Smith and Teresa Welch introduce the fundamentals of reading a balance sheet. It is our hope that nurse leaders find this information useful for either their own practice or share with a novice colleague seeking to develop financial competencies. It would also be useful for including in a graduate finance course in nursing programs.
We hope that this collection of articles adds valuable strategies and insights into your leadership tool kit.
-Nora Warshawsky, PhD, RN, NEA-BC, CNE, FAAN
Associate Editor
Nursing Administration Quarterly
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