Leading Through the Unknown: A Network Perspective of the COVID-19 Pandemic.

This article provides a road map to swiftly operationalize the structure and process for organizational readiness in response to the COVID-19 pandemic. The pandemic forced network leaders to face an unprecedented public health crisis while navigating circumstances driven by a widely impactful disease with minimal empirical evidence regarding disease spread, containment, and treatment. Key leaders across the enterprise planned, executed, and continually refined a strategy against the pandemic surge. Mission-driven decisions, communication, and actions were critical in connecting and informing the stakeholders about the evolving and uncertain conditions. In partnership with internal and external stakeholders, the use of data, technology, and innovation provided new opportunities to transform existing care and business models into adaptable prototypes for mitigating risks and informing tactical steps. Execution of testing sites, building a command center, and increasing bed capacity infused daily operations. Creating innovative processes, including working with private industry to secure resources and pioneering solutions, is the result of leveraging talented teams to produce solutions. Trustful partnerships among enterprise leaders and their constituents stemmed from a common, shared vision. Utilizing systems thinking led to optimizing a response and preparedness plan for now and for future pandemics.

Effect of the Salary Model on Sustainability of a Professional Practice Environment.

OBJECTIVE: This replication study examined differences in RN perception of the professional practice environment (PPE) between salary- and hourly-wage compensation models over time. BACKGROUND: A previous study demonstrated that nurses in a salary-wage model had a significantly higher perception of the PPE compared with their peers receiving hourly wages. METHODS: A descriptive, comparative design was used to examine the Revised Professional Practice Environment (RPPE) scale of nurses in the same units surveyed in the previous study 2 years later. RESULTS: Mean scores on the RPPE continued to be significantly lower for hourly-wage RNs compared with the RNs in the salary-wage model. CONCLUSIONS: Nurses in an hourly-wage unit have significantly lower perceptions of the clinical practice environment than their peers in a salary-wage unit, indicating that professional practice perceptions in a salary-wage unit were sustained for a 2-year period and may provide a more effective PPE.

A comparison of salary-wage and hourly-wage acute care nursing units: a pilot study.

OBJECTIVE: This pilot study examined differences in RN perception of the professional practice environment and financial indicators between salary-wage and hourly-wage compensation models. BACKGROUND: There is a dearth of current information regarding use of salary-wage models for compensation for direct care nurses. METHODS: A descriptive, comparative design was used to examine the Revised Professional Practice Environment Scale (RPPE) and financial indicators of nurses in a nonprofit healthcare system over a 6-month period. RESULTS: Mean scores on the RPPE were significantly lower for hourly-wage RNs, and the hourly-wage model resulted in a 1.2% additional cost for overtime hours compared with the fixed cost of the salary-wage model. CONCLUSIONS: Nurses in an hourly-wage unit reported a significantly lower perception of the clinical practice environment than did their peers in a salary-wage unit, indicating that professional practice perceptions in a salary-wage unit may provide a more effective professional practice environment. Financial analysis resulted in a budget-neutral impact.