An Interview With Susan Reinhard.

This column addresses how AARP, a consumer organization, is leading a Center for Health Equity through Nursing. The Center is working to support nursing to mitigate the nursing workforce crisis. Susan C. Reinhard is a senior vice president at AARP, directing its Public Policy Institute (PPI), the focal point for public policy research and analysis at the state, federal, and international levels. She leads PPI's family caregiving initiatives and serves as the chief strategist for the Center to Champion Nursing in America, a national resource center created to ensure that America has the highly skilled nurses it needs to provide care in the future. As a previous deputy commissioner of the New Jersey Department of Health and Senior Services, Reinhard led the development of policies and nationally recognized programs for family caregiving, consumer choice, and community-based care options. She is a fellow of the American Academy of Nursing, the Gerontological Society of America, and Salzburg Global. She holds a master's degree in nursing and a PhD in sociology.

Creating a Legacy of Leadership.

Every nurse leader knows there are challenges that face us as we lead in complex organizations. This column will focus on the sage advice and insights of 5 nurse leaders, who have chosen to share an authentic legacy of lessons learned, successes, challenges, and their reflections on leadership through the creation of a book about organizationally minded nurse leaders. Catherine Gilliss, Bobbie Berkowitz, Jean Johnson, Paula Milone-Nuzzo, and Pat Reid Ponte have worked together to write a book titled Organizationally Minded Nursing Leadership.

Components of Professional Practice Models.

OBJECTIVE: This study describes common components of nursing professional practice models (NPPMs) of Magnet ® -designated nursing service organizations. BACKGROUND: Components of professional practice models have not been consistently analyzed, suggesting a need to identify their concepts. Evidence-based guidelines may be unavailable to assist in the creation and revision of models. METHODS: A checklist was used to analyze 56 Web-based NPPMs of Magnet-designated nursing departments. RESULTS: Checklist items showed a match with parent organizations, an emphasis on patient- or family-centered care, a commitment to quality nursing services, and nursing's professional distinctiveness. Responses indicated engagement in shared governance and support of nursing staff's professional development. The concepts of health, care of sick and well people, and scope of nursing services were inconsistently addressed and call for further research. CONCLUSION: Nurse leaders should examine concepts in NPPMs and the extent they distinguish nursing's professional identity both within and externally to the organization.

The Business Case for Magnet ® Designation : Using Data to Support Strategy.

The Magnet® journey has increased in relevance as the sources of evidence reflect the complex role of the nurse in quality, safety, and the patient care experience. Creating a business case to secure the resources required to embark and travel on the Magnet journey is an essential tool for the chief nurse. Identifying expenses, cost savings or avoidance, and return on investment for nursing services are all important elements of a business case.

It Is Time to Focus Digital Strategy on Supporting Nurse Workflow.

In this column, 2 recognized healthcare leaders discuss the stresses experienced by nurses in today's workforce and offer suggestions for the use of technology in improving nurse engagement as well as the quality of patient care.

Chief Nursing Officer Perspectives on Nursing Theory-Guided Practice.

OBJECTIVE: The purpose of this study was to identify what guides nursing practice. BACKGROUND: Change occurred when the Magnet Recognition Program® no longer required a nursing theory. METHODS: This was a mixed-methods study to identify the process used to implement nursing theory-guided practice and the relationship to professional practice recognition. Deidentified quantitative data were collected from 36 chief nursing officers (CNOs). Seventeen CNOs participated in the qualitative interview. RESULTS: Thirteen CNOs were from a Magnet®-designated facility. Ten CNOs were on the Magnet journey, and 2 had no intent to seek Magnet recognition. Two CNOs were from a Pathway to Excellence®-designated facility. One CNO was on the Pathway to Excellence journey. The majority of respondents who were Magnet® recognized who participated in the survey used Watson's Theory of Human Caring. Themes were identified that share the benefits and strategies to integrate nursing-guided theory into nursing processes, structures, and outcomes. CONCLUSION: Findings will benefit CNOs as they make decisions related to pursuing Magnet status recognition.

Advocating for Nursing Research: The Friends of the National Institute for Nursing Research (FNINR) Ambassador Program.

The National Institute of Nursing Research (NINR) has a Friends group. This organization, the Friends of the National Institute of Nursing Research (FNINR), has been in place for over 20 years. It serves as a bold voice to communicate the impact of NINR's work to elevate nursing science, improve lives, while advancing the nation's health. FNINR's mission is to provide resources to support nursing research and advance the mission of the NINR. In 2013, the FNINR led the creation, development, and growth of an Ambassadors Program. The Ambassador Program is a group of committed individuals who are willing to serve as advocates of the NINR. Chosen through an application process reviewed by the FNINR Advocacy Committee of the FNINR Board, these selected Ambassadors work to influence Congress and advocate for the goals and visions of the NINR. This designation was initially limited to an elite group, and peer networking and communication was built into the program. The goal of the FNINR Ambassadors Program is to extend the reach of advocacy efforts for improving the funding and knowledge about the NINR. Thirty ambassadors across the country are working to expand knowledge and educate stakeholders about the impact of nursing science on the health of the country. This article describes the process the FNINR conducted to develop the Ambassadors Program, and the outcomes associated with this program.

Engaging Employees in Well-Being: Moving From the Triple Aim to the Quadruple Aim.

Anne Arundel Medical Center has been on a 3-year journey to improve employee well-being with the assumption that employee well-being and employee engagement are interconnected. Improvements in employee well-being will result in increased employee engagement and will be a pivotal driver to assist the health system meet its goals. Historically, Anne Arundel Medical Center successfully differentiated itself in the market by being the region's high-quality, low-cost provider of health services delivered through intense collaboration with patients and families. The financial, quality, and patient satisfaction results are in the top percentiles nationwide. However, as the pace of change accelerates and the organization faces increased pressure to improve outcomes, keeping employees from becoming burned out and disengaged becomes an increasing concern. The WellBeing framework was developed on the basis of the work of Tom Rath and Jim Harter as the model to support Anne Arundel's WellBeing work. The efforts around well-being are comprehensive and impact all aspects of how work is conducted. Employee well-being has been elevated to an equal third prong along with providing high-quality low-cost care in a patient-centered environment. This focus on leading an employee WellBeing Program has resulted in improved engagement scores at Anne Arundel Medical Center.

Nurse Manager Competencies Supporting Patient Engagement.

Patient engagement is an important element in transitioning care delivery to achieve population health management goals. Providers are challenged to develop care delivery processes that better engage patients in their life journey across the healthcare continuum. Nurse leaders are central to this process. Building upon the American Organization of Nurse Executives competencies for nurse executives, the nurse manager role requires specific skills to translate the vision of patient engagement into practice.

Interactive Care Model: A Framework for More Fully Engaging People in Their Healthcare.

Transformation of care delivery requires rethinking the relationship between the person and clinician. The model described provides a process to more fully engage patients in their care. Five encounters include assessing capacity for engagement, exchanging information and choices, planning, determining interventions, and evaluating the effectiveness of engagement interventions. Created by researchers and validated by experts, implications for practice, education, and policy are explored.

Patient and Family Engagement Summit: Needed Changes in Clinical Practice.

Patient and family engagement is a strategy to enhance healthcare outcomes through strong clinician-patient partnerships. A new care delivery process, in which the patient is the driver of the healthcare team, is required to achieve optimal health. A summit partially funded by a seed grant from the Robert Wood Johnson Executive Nurse Fellow Alumni Foundation was held with interprofessional colleagues and patient representatives to identify needed clinical competencies and future practice changes. Recommended shifts in the care delivery process included a focus on patient strengths, including the patient as a valued team member, doing care "with me" and not "to me," and considering all entities or providers including the patient, as equal partners.

Coordinating Care: Shifts in Perspective.

Effective coordination of care has consistently been a challenge for clinicians, care providers, and systems of health care. The health care system is inherently fraught with unorganized and disparate parts including multiple points of entry. A review of the current issues and the leadership implications is explored in this article with an emphasis on patients becoming more actively engaged in managing their care journey across the continuum. A case study of a primary care clinic in Annapolis, Maryland, is described to illustrate the application of evidence-based leadership skills, knowledge, and a framework to transform health care to more effectively engage patients in their care. As the constant on the continuum of care, the engaged patient is in the unique position to manage coordination, thus ensuring continuity.

Interactive Care Model: A Framework for More Fully Engaging People in Their Healthcare.

Transformation of care delivery requires rethinking the relationship between the person and clinician. The model described provides a process to more fully engage patients in their care. Five encounters include assessing capacity for engagement, exchanging information and choices, planning, determining interventions, and evaluating the effectiveness of engagement interventions. Created by researchers and validated by experts, implications for practice, education, and policy are explored.

Influencing and impacting the profession through governance opportunities.

In addition to board leadership of health care organizations and corporations, there are strategic opportunities for nurses to participate in professional association boards and commissions and expert panels. These boards have specific and unique challenges and opportunities, and it is important for nurse leaders to serve in shaping the direction of the profession. Nursing as a profession has an opening to solve many of the care delivery issues that face the country. A strategic contribution to association boards and commissions can influence the health care delivery system changes needed to improve quality of care, access to care, and reducing costs. This article describes similarities and differences of service on association boards and commissions compared with organizational and corporate boards. Through these leadership roles, the larger community can observe influential nurses in an essential role. These leadership opportunities, including membership boards, commissions, and content expert panels, call for a special understanding of those governance structures and the contributions that nurse leaders can make to impact health care. Association and membership organizations have undergone many changes in the past 10 years, and new models of governance and leadership have been called into play. There are challenges and opportunities in serving on these boards and commissions. Maximizing the leadership and governance roles of this type of service is a critical contribution that nurses can make to impact the profession of nursing and the greater health care system.

The Power of Alignment: Educating Nurses in Quality and Safety.

The Quality and Safety Education for Nurses (QSEN) grant was launched over 5 years after the Institute of Medicine's report that shared the stark truth about medical errors. The 4 phases of QSEN have provided a roadmap for nursing prelicensure and graduate students to integrate quality improvement and safety content into educational programs. By fully aligning the resources of academic programs with health care organizations, a more robust and comprehensive approach could be taken to ensure that all nurses receive the benefit of the most up-to-date and thorough education about quality and safety.

The Application of Gaming Theory in Health Care.

As the US health care system moves rapidly toward a population health management focus in communities and care settings, the chief nursing officer has an opportunity to lead innovation efforts for patient care. One innovative strategy for use to influence patient behavior change, ongoing clinical education, and prelicensure education is the application of gaming theory into learning strategies. With the ever-increasing emphasis the general public is placing on social media and online gaming, there has been a significant push by the health sector in recent years to harness this medium for use in health management, education, and behavior change. A number of organizations and insurers have dedicated significant resources to researching and developing games and apps to help patients manage diseases, track self-management activities, and motivate behavior change for healthy lifestyles. This article shares information about gaming theory and its application to health care including a review of the science behind the theory, the use of technology, and gaming education strategies for both patients and clinicians.

Nurse credentialing research: a huge step forward.

This month, the executive director of the American Nurses Credentialing Center discuses the importance and impact of supporting a national credentialing nursing research agenda.