The previous 2 issues of Nursing Administration Quarterly have been devoted to creativity and innovation in nursing and in healthcare. The focus on creativity and innovation is timely in so far as the realities of the 21st-century quantum age significantly impact all of healthcare. There is no greater need for innovative insight and leadership than that which exists in the contemporary healthcare system. In addition to technical and therapeutic transformation, emerging sociopolitical realities create conditions that will drive reconceptualization and redesign of the American healthcare system. All these realities and the focused efforts necessary to address them call for an entirely new leadership capacity.
Emergent theories and applications of leadership are now beginning to reconfigure the leadership landscape for 21st-century organizations. In addition, as the nursing profession emerges into full adulthood, the realities of leading a profession differ significantly from leadership activities associated with managing employee work groups. A professional's motives, activities, sense of self, and identification with the profession alter the rules of work relationship, motivation, and management. As much of the research on leadership and professional roles generated from the Magnet Recognition Program indicates, the ability to sustain professional clinical excellence calls for different more equity-based relationships and interactions between nurses, other disciplines, and the organization.
For this reason, we think that emphasis on the leadership of innovation is a critical issue for nurse leaders. Much of the activity of leadership today and for the foreseeable future will require good predictive and adaptive leadership skills from every level of nurse leader. Helping the profession and the professional move through every stage of systems transformation and practice innovation is no longer an option for the profession, the organization, and those who lead both. Competencies necessary to read the contextual signposts indicating sociopolitical, economic, and technological transformation and the destructive technologies they create will inform the leader of role for decades to come. As a result, leaders in every capacity must now recognize that shifting their own frame of reference for leadership and their understanding of the prevailing competencies in exercising it are no longer optional to the role. In a health system now driven by service and technological portability and mobility, supported by an ever-expanding array of digital tools, nurse leaders now must recognize their need and ability for managing flow and ever-constant movement.
At the same time, innovation is a discipline with its own characteristics and structure. The level of ownership, investment, and engagement from all stakeholders is accelerated in the innovative milieu and the leader must be able to negotiate a high level of intensity in relationship, intersection, and interaction. The interface between the larger social context organizations, providers, and people requires system leadership to facilitate, integrate, and coordinate all levels of relational dynamics necessary to guide stakeholders on an innovation trajectory that leads to a continuing success and sustenance. These leaders must now move diverse participants in a common direction beneficial to each and valuable to all and requires deep leadership capacity for "setting the table," facilitating dialogue and decision making, encouraging full participation, and achieving a product that advances real value and makes a contribution.
We hope this diverse collection of authors and articles will help challenge the nurse leader to rethink past leadership skills and begin to form a leadership compact with self and others around learning and applying truly innovative approaches to decisions and actions in a contemporary clinical context. Like any other human endeavor, the leadership learning journey is endless and calls each of us to reflect on our own leadership plan for continuing growth. As leaders, if we are not committed to our own learning and growth along the innovation pathway, it will be difficult to ask those we lead to do so. The door to innovation is now fully open; the excitement and joy of the creative enterprise is on the other side-we need only walk through. The script for the future is written while we live it and the best way to predict the future is to create it.
Tim Porter-O'Grady, DM, EdD, APRN, FAAN
Kathy Malloch, PhD, MBA, RN, FAAN
Senior Partner, Tim Porter-O'GradyN Associates, Inc, Otto, North Carolina (Porter-O'Grady)
President, Kathy Malloch & Associates, Inc, Program Director, Master of Health Care, Innovation Program, College of Nursing, Arizona State, University, Phoenix (Malloch)