Leadership presence: A concept analysis.

AIM: To examine the concept of Leadership Presence. BACKGROUND: Presence is an essential factor in a leader's repertoire. However, the concept is not well-defined, or the significance understood on how leadership presence affects individual and organizational outcomes. DESIGN: Walker and Avant's modified method of concept analysis DATA SOURCE: Literature from multiple scholarly databases were searched. The search terms "leadership," "presence," "physical presence," and "leadership presence" were imputed using established inclusion criteria: full text, peer-reviewed, and printed in the English language from 2016 to 2021. REVIEW METHODS: Articles examined to determine the context of leadership presence and to understand and identify the antecedents, attributes, and consequences of leadership presence. RESULTS: Eighteen articles met inclusion criteria and were examined. Antecedents consisted of elements that represented the internal complexity of the organization and the presence of external threats. Attributes included a leader's emotional intelligence, a vision for improvement, and a commitment to successful caring and patient outcomes. Consequences evolved from organizational and individual elements of leadership presence. CONCLUSION: By understanding the concept of leadership presence, nurse leaders can appreciate the meaning, implications, and contributions of this concept and employ leadership factors that influence nurse, patient, and organizational outcomes.

Implementation and evaluation of IGNITE (Improving GME Nursing Interprofessional Team Experiences) to improve care in an academic health system.

Engaging residents with nurses in interprofessional performance improvement teams can improve learning and care. Residents at the University of Chicago Medicine were identified by nurses, and endorsed by program directors, to serve alongside nurses in Improving GME Nursing Interprofessional Team Experiences (IGNITE) teams. Teams met monthly with improvement coaches to implement institutionally aligned improvement plans. Institutional data was used to monitor progress. The Interprofessional Collaborative Competencies Attainment Survey (ICCAS) assessed interprofessional collaboration competency. Press Ganey Clinician Engagement (PGCE) data examined year over year differences in items related to teamwork comparing IGNITE units and non-IGNITE units. Length of stay (LOS) differences were also examined. From 2015 to 2019, IGNITE spread to 9 service lines engaging over 100 residents and nurses. Unit-based teams focused on adding nurses to attending rounds, implementing nurses-resident huddles, and improving multidisciplinary rounds. ICCAS scores significantly improved. PGCE data showed year over year improvements in composite teamwork and communication scores in IGNITE units. All adult inpatient IGNITE units saw a mean LOS reduction ranging from -0.15 days to -1.16 days, equating to an estimated cost savings of nearly 3 million dollars per quarter. Lessons learned include: 1) the importance of engaging hospital leadership; 2) the need to align collaborative practices with institutional goals; 3) the critical role of coaching; and 4) practices to ensure committed, consistent participants.

Integrating Physicians Into Lean Quality Improvement Through a Structured Educational Program: The ECLIPSE Program.

In the increasingly complex health care system, physicians require skills and knowledge to participate with multidisciplinary team members in quality improvement (QI) that adds value to health care organizations. The Educational and Clinical Leaders Improving Performance with Structured E3L training (ECLIPSE) program was developed to address this challenge. Clinically relevant components of lean management were leveraged to create an online, flipped-classroom curriculum, and this was paired with Kaizen adapted specifically for physicians and multidisciplinary clinicians to promote experiential skills utilization. The focus of each adapted Kaizen was a topic of institutional QI priority, such as improving patient throughput or reducing readmission rates. Participants were awarded certification in the E3 Leadership management system-a patient-centered, equity-focused system based on lean principles. After 4 years, 50 E3 Leadership certificates were awarded to multidisciplinary clinicians, including 30 to physicians; participants scored an average 85% on module quizzes. The ECLIPSE program has improved physician participation in multidisciplinary QI projects with institutional alignment.

The Power in Coming Together.

The role of the chief nursing officer is multifaceted and complex. These complexities can be exacerbated during times of turbulence, specifically the COVID-19 pandemic. Understanding communication and collaboration are core to achieving optimal outcomes, this article outlines the experience of 3 chief nursing officers through the COVID-19 pandemic and the value of a structured platform for peer shared learning and support.

Building a team through a strategic planning process.

Strategic planning is a process often left to senior hospital leadership, with limited input from unit-level, bedside patient care providers. This frequent approach to strategic planning misses the opportunity to engage a wide range of employees, build a shared sense of commitment, produce a collaborative team environment, and to generate greater acceptance of the plan. The Patient Care Services division at the University of Chicago Medicine used a strategic planning process that incorporated 360-degree input from both within the Patient Care Services division and outside of the division. The result is a strategic vision and plan that, shaped by broad-based input from both internal and external constituencies, is strengthened by the team that emerged from the process. Through the process of identifying a common understanding of the group's future direction, a shared purpose was created that transcended traditional professional boundaries and shaped a cohesive team focused on effective and efficient patient care. Now, with a focused strategic plan and a team centered on a shared purpose, the team is beginning to effectively deliver on the plan.