Developing a Culture of Support to Advance and Accelerate Nursing Innovation.

Nurses everywhere are called to seek new and better ways of providing care in the complex and dynamic environments where they practise. The core of innovation is the creation of new ideas and use of existing ideas in new ways or in new settings. Today, innovation and fresh thinking are more important than ever as the world is changing rapidly and complexity is the norm. Nurse leaders are called to action to create the insights, cultures, structures and methodologies needed to promote the development and uptake of innovative ideas in nursing practice and interdisciplinary team work. This paper highlights three successful examples of nursing leadership in the development of a culture of innovation at the national (SE Health), provincial (Registered Nurses Foundation of Ontario's Nurse Innovator Awards) and local (Sinai Health) levels. The goal of these initiatives is to cultivate innovation as a way of being, thinking and doing, ensuring that it is inherent in nursing culture and visible in nursing practice, education and research that enhances patients' and care partners' experiences.

Building Healthcare Leadership Capacity: Strategy, Insights and Reflections.

The Dorothy Wylie Health Leaders Institute is a Canadian success story, providing leadership development to over 2,600 nurses and healthcare professionals since its inception in 2001.The authors describe the original design and intent of the Institute and its evolution over the last 18 years as both the context for leadership and leadership requirements have evolved. The Institute's framework, key features, principles, concepts and streams of learning are outlined along with summaries of research on personal and organizational impact. Lessons learned and recommendations are included in the areas of program design, registrant selection and organizational support. This paper will be of interest to those who wish to better understand how the context of leadership in healthcare is evolving and how leadership attributes and behaviours can be developed to meet current and new challenges.

Promising practices in leadership development.

The authors describe what they have learned from 10 years as designers and facilitators of the award-winning Dorothy Wylie Nursing and Health Leaders Institutes. Since 2001 they have offered 23 institutes to over 2,200 existing and emerging health leaders to promote their leadership development and learning. As well, they have supported the development and execution of close to 900 leadership application projects initiated by participants for their organizations. The authors offer knowledge and insights related to three key areas: (a) the individual (the leadership aspirant or learner), (b) the organization's role in supporting leadership development and (c) leadership program design.

Transport of Bacillus thuringiensis var. kurstaki via fomites.

The intentional and controlled release of an aerosolized bacterium provides an opportunity to investigate the implications of a biological attack. Since 2006, Los Alamos National Laboratory has worked with several urban areas, including Fairfax County, VA, to design experiments to evaluate biodefense concepts of operations using routine spraying of Bacillus thuringiensis var. kurstaki (Btk). Btk is dispersed in large quantities as a slurry to control the gypsy moth, Lymantria dispar. Understanding whether personnel and equipment pick up residual contamination during sampling activities and transport it to other areas is critical for the formulation of appropriate response and recovery plans. While there is a growing body of literature surrounding the transmission of viral diseases via fomites, there is limited information on the transport of Bacillus species via this route. In 2008, LANL investigated whether field sampling activities conducted near sprayed areas, post-spray, resulted in measurable cross-contamination of sampling personnel, equipment, vehicles, and hotel rooms. Viable Btk was detected in all sample types, indicating transport of the agent occurred via fomites.

An integrated approach to change leadership.

Leading change has become one of the essential core competencies of health professionals today. Since 2001, the authors have been the key designers and facilitators of the Dorothy Wylie Nursing Leadership Institute (DMW-NLI). The background, key characteristics and benefits of the DMW-NLI have been described in detail elsewhere (Simpson et al. 2002). One of the Institute's key features is that participants bring a change initiative that they wish to pursue and - during their time on site - we assist them in developing that project to the point where it has a strong chance of success. When we incorporated this aspect into the DMW-NLI program, we believed that opportunity to apply the learning of the Institute to a desired initiative in the home setting would add significant value, not only to the participants, but also to their sponsoring organizations. Further, it was our hope that we could develop a methodology to advance the change initiative, which would be a valuable tool that participants could use in future change projects.As we looked to the literature, we found no shortage of articles on change theory, as well as numerous tools and techniques for project management. However, we did not find one single approach or methodology that we felt was comprehensive yet concise enough to serve as a practical guide for those who wish to advance a change initiative in their practice settings today. Therefore, we developed an integrated conceptual framework and methodology for leading change initiatives, building on selected current and classic theories of change that are relevant today. Both the framework and methodology have proven very hardy, and will, we believe, be of interest to nurse leaders and other health professionals in leadership roles. This paper will provide a brief overview of relevant background literature on leading change initiatives, introduce the DMW-NLI Change Leadership conceptual framework, describe a number of activities that support the framework, and conclude with a summary of its impact to date and implications for leaders and managers.

Building capacity in nursing: creating a leadership institute.

The authors describe the development of the Dorothy M. Wylie Nursing Leadership Institute, an innovative partnership of the Nursing Effectiveness, Outcomes and Utilization Research Unit at the University of Toronto site and nurse consultants with expertise in organizational and human resource development. The context for the initiative, needs and rationale, supporting literature and the coalition-building and planning activities are outlined. The program and its conceptual underpinnings, creation of a learning community, participant profiles, evaluation processes and future plans are described.