An Organizational Commitment to Diversity, Equity, Inclusion, and Justice: A Multipronged Strategic Approach.

Cedars-Sinai is a sixth continuous Magnet organization in Southern California that embodies inclusive leadership in support of diversity, equity, inclusion, and justice (DEIJ) principles. The organization adheres to a strategic model prioritizing staff sense of belonging, empowerment, engagement, curiosity, and creativity. Employing inclusive leadership, we have implemented strong programs of professional development and continuous learning, innovation, and research. This leadership and these programs have fostered a culture of inquiry, support evidence-driven practice, quality improvement, and staff engagement. Our organization is committed to creating a caring and healing environment that promotes performance. We believe in practicing loving-kindness toward ourselves and others as a core value. Executive leadership support has been a key element in our successful implementation of DEIJ strategies, including employee resource groups, Shared Leadership Councils, transition to practice programs, health equity research, and innovative solutions. These strategies have been shown to yield a significant return on investment.

From Competence to Continuing Competency.

In 2011, a task force sponsored by an organization that has Accreditation Board for Specialty Nurse Certification-accredited programs published a definition of continuing competence. Eight years later, the organization sponsored the work of another task force to revisit that definition, with the 2018-2019 task force broadening its focus beyond the U.S. borders and beyond nursing. After an extensive literature review, task force members collated their findings into four categories: Identifying Competencies, Validating Competencies, The International Perspective on Competency Assessment, and Competency in Disciplines Other Than Nursing. The task force identified perspectives on continuing competency and found that although licensing and credentialing organizations addressed the topic thoroughly, little attention was devoted to the perspectives of the public, individual clinicians, and recipients of clinicians' services. This article identifies that little consensus exists on definitions of competence and competency, international perspectives have much to offer, and theoretical frameworks for research on competence and competency are lacking. [J Contin Educ Nurs. 2020;51(1):15-24.].

Unleashing the Power of Nurse Innovators.

In this month's Magnet® Perspectives column, guest author Dr David Marshall, JD, DNP, RN, CENP, NEA-BC, FAAN, system chief nursing and patient care services executive at the University of Texas Medical Branch (UTMB), explores nursing's proud history of innovation and looks at ways we can give nurses the means, opportunity, and motivation to unleash innovation and transformation. Dr Marshall shares details of UTMB's successful medical makerspace, where nurses and others bring ideas to life.

Teamwork: an essential for leading and launching innovation.

Teamwork and innovation require a merging of special skills sets to produce the best outcomes. Collaboration and innovation have become core competencies for effectiveness in every industry. The capacity to collaborate and innovate has never been more important, especially in health care, with the regulatory and quality mandates to evaluate every aspect of service to ensure that we add value for patients and families. The examination of teamwork and innovation, which are inextricably linked, are described and discussed. The art of building teams, steps for leading change, and an approach to innovation in health care are described. The University of Texas Medical Branch in Galveston, Texas, shares one approach and experience called Innovation Forerunners-nurses from all levels and areas-to embed the tools and concepts of teamwork and innovation across patient care areas.

Crew resource management improved perception of patient safety in the operating room.

To improve safety in the operating theater, a company of aviation pilots was employed to guide implementation of preprocedural briefings. A 5-point Likert scale survey that assessed the attitudes of operating room personnel toward patient safety was distributed before and 6 months following implementation of the briefings. Using Mann-Whitney analysis, the survey showed a significant (P < .05) improvement in 2 questions (of 13) involving reporting error and 2 questions (of 11) involving patient safety climate. When analyzed by occupation, there were no significant changes for faculty physicians; for resident physicians, there was a significant improvement in 1 question (of 13) regarding error reporting. For nurses, there were significant improvements in 3 questions (of 4) involving teamwork, 1 question (of 13) involving reporting error, and 3 questions (of 11) regarding patient safety climate. These results suggest that aviation-based crew resource management initiatives lead to an improved perception of patient safety, which was largely demonstrated by nursing personnel.

Improving perceptions of patient care--a nursing education and nursing practice initiative.

In January 2005, the University of Texas Medical Branch (UTMB) School of Nursing and the UTMB Hospitals and Clinics launched the first phase of a project to improve perceptions of patient care on the part of nursing faculty and nursing clinicians. A finding on the UTMB annual employee satisfaction survey that nursing faculty and clinicians tended to rate quality of UTMB patient care lower than other UTMB employees provided the impetus for the initiative. When UTMB colleagues noticed the findings, various entities including human resources and the Faculty Senate called for explanations from the dean of the School of Nursing, the chief nursing officer, and the CEO for the hospitals and clinics. In the process of attempting to give reasons for the findings, each of us determined we would take definitive action to address the situation. This article describes our accomplishments for Phase 1 of the initiative. Beginning with a vision for a productive professional community characterized by a pedagogical partnership between nursing education and practice, we share the processes we followed to (1) achieve mutual understanding among task force members, (2) obtain input on perceptions from nursing colleagues, (3) identify the clinical and nursing education aspects of the perceptions, (4) reach consensus on target perceptions for Phase 2 of the project, and (5) outline the next steps for the project.

A concise synthesis of the octalactins.

The total synthesis of octalactins A and B has been achieved in 15 steps (longest linear sequence) and 10% overall yield from commercially available materials. Key steps include the Paterson-Aldol reaction for the rapid assembly of the carbonate 46, methylenation of 46 and subsequent Claisen rearrangement of the corresponding alkenyl-substituted cyclic ketene acetal to provide the core unsaturated medium-ring lactone 47, and the use of enzyme-mediated acetate deprotection in the presence of a medium-ring lactone.