Long-Term Care Nurse Leaders Find Calm in Chaos: Reflections from a CEO during a Global Pandemic.

Loch Lomond Villa is one of the largest long-term care communities within the province of New Brunswick. Our organization supports caring living environments for over 450 clients and their family members along with 354 employees.

Chief Nurse Executives involuntary turnover in times of health care reforms: Findings from an interpretative phenomenology study.

In recent years, due to several health care system reforms in different countries, an increased involuntary turnover rate of Chief Nurse Executives has been reported around the World. However, no data on their perceived experience of their dismissal have been documented up to now in the European context. Describing the experience of involuntarily dismissed Chief Nurse Executives was the main aim of this interpretative phenomenological study. Data were collected through face-to-face audiotaped interviews performed by involving a purposeful sample of 13 Chief Nurse Executives; data analysis was performed by using the QSR NVIVO 11 software. The Chief Nurse Executives' experience of Being fired is characterized by three main themes: (1) "Health Care Institutions are places influenced by political turbulences"; (2) "My competence and presence in the arena is despised by a range of strategies"; and (3) "Transiting from darkness to light". According to their experience, the reason for dismissal was due to changes in the political climate and the introduction of a new chief executive officer; moreover, Being fired caused a deep pain similar to that experienced during bereavement. In some socio-political contexts, the political climate can influence the role of a Chief Nurse Executive: political membership, whether implicit or explicit, is considered of great value. In other contexts, the Chief Nurse Executives' value is based on professional competences and achieved outcomes. At times of changes in the political climate, the peculiarities of the specific socio-political context should be evaluated as to whether one should anticipate his/her resignation or not.

Sofrimento moral de enfermeiros gerentes em um hospital universitário / Nurse managers' moral suffering in a university hospital / Sufrimiento moral en enfermeros gerentes de un hospital universitario

Objetivo: Descrever situações geradoras e elementos envolvidos no processo de sofrimento moral na experiência de enfermeiros gerentes de um hospital público do sul do Brasil. Método: Estudo descritivo e exploratório de abordagem qualitativa, realizado durante o período de março a setembro de 2014 cujas informações foram coletadas mediante entrevista semiestruturada. Participaram da pesquisa 17 enfermeiros gerentes. Os dados foram organizados no software Atlas.Ti© e analisados segundo a técnica de análise textual discursiva. Resultados: Emergiram três categorias: Organização e Condições de trabalho, Gestão de Pessoas e O Ser Gerente. Conclusão: Constatou-se que os gerentes vivenciam o sofrimento moral decorrente de situações conflituosas relacionadas às condições de trabalho, profissionais insubordinados, falta de autonomia, assédio moral e as múltiplas faces da função gerencial. Assim, buscou-se contribuir para área da saúde, nos aspectos de sensibilizar moralmente os profissionais para as atividades que desempenham e no tocante ao sofrimento moral

Objective: Describe generating situations and elements involved in moral distress process in nurse managers experience of a public hospital in southern Brazil. Method: Descriptive and exploratory study, nature of qualitative approach, conducted from march 2014 to september 2014 and whose information was collected through semi-structured interview. There was a participation of 17 nurses managers. Data were organized in the software Atlas. Ti© and analyzed according to the technique of discursive and textual analysis. Results: Three categories emerged: Organization and working conditions, People management, and Being the Manager. Conclusions: It was found that the managers experience moral distress arise from conflicting situations related to working conditions, insubordinate professionals, lacking of autonomy, psychological harassment and the multiple faces of the managerial function. Accordingly, it was sought to contribute to the health area, in the aspects of morally sensing the professionals for the activities they perform and regarding moral distress

Objetivo: Describir la generación de situaciones y elementos relacionados con el proceso de sufrimiento moral en enfermeros gerentes de un hospital público en el sur de Brasil. Método: Estudio descriptivo y exploratorio de enfoque cualitativo, realizado durante el período de marzo a septiembre de 2014 y cuyas informaciones fueron obtenidas por medio de entrevista semiestructurada. Participaron de la investigación 17 enfermeros gerentes. Los datos fueron organizados en el software Atlas.Ti© y analizados de acuerdo con el método de análisis textual discursiva. Resultados: Se desarrollarán tres categorías: Organización y Condiciones de trabajo, Gestión de personas, y el Ser Gerente. Conclusión: Se concluyó que los gerentes experimentan el sufrimiento moral resultante de situaciones conflictivas relacionadas con las condiciones de trabajo, profesionales insubordinados, falta de autonomía, acoso moral y las múltiples facetas de la función gerencial. Así, se buscó contribuir al área de la salud, en los aspectos de sensibilizar moralmente a los profesionales para las actividades que desempeñan y en lo tocante al sufrimiento moral

Preparing Chief Nurse Successors: An Evaluation of the Chief Nursing Officer Academy.

The traditional role of the chief nursing officer (CNO) is expanding to include new clinical areas and patient populations. Chief nursing officers find themselves challenged to balance both system and site priorities, compounded with the expectation to lead their organization during a merger, acquisition, or hospital closure and the changes in healthcare reimbursement. Chief nursing officers must anticipate emerging issues and be prepared to manage those issues. They are at high risk politically when a new chief executive officer is named and when hospitals are having financial concerns. How do we lead in times of turbulence? How can we ensure that high-potential candidates are prepared for the CNO role and what are the most critical competencies they will need? To address these concerns, we created a Chief Nursing Officer Academy (CNOA) that is designed for new and aspiring CNOs. This article provides an overview of the CNOA and a program evaluation of the outcomes for the participants.

Closing the Gap: Executives and Student Perceptions of Leadership Characteristics for Health Care Managers.

A study was recently conducted to determine the perceptions of undergraduate health care management students regarding leadership characteristics that health care managers should possess to be successful. The results were then compared with a study that was conducted in 2012 of chief executive officers regarding their perceptions of the same leadership characteristics. The comparison of the studies was used to determine if the perceptions of the students and chief executive officers were similar or if the subjects considered different characteristics more important than others.

Chief executives: singled out for glory or stress?

The chief executive role might be seen as the pinnacle of achievement for any executive working in a trust, but there is growing evidence that suggests many are reluctant to step up to the role.

Hospital Consumer Assessment of Healthcare Providers and Systems: An Ethical Leadership Dilemma to Satisfy Patients.

This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

[The Health Care Revenue Cycle. Management in Brazil: Challenges that keep CEOs awaken].

Brazil's economic and political crisis had never been deeper, hardening the way companies deal on the market. Only those that are able to deal with tougher market conditions remain in the game, while facing increasingly difficult situations. A continuous rise in competition has shrunk prices and compressed margins, imposing necessary improvements to the way companies work in order to remain sustainable. The healthcare market is no exception, and if leaders identify improvement opportunities for the way their companies deal with Revenue Cycle Management, they will easily be one step ahead of competition.

THE NEW CEO.

Traditional management skills are still crucial when it comes to keeping hospitals and health systems running smoothly, but as health care changes dramatically, boards also must consider "learning agility" and "emotional intelligence" when working with the C-suite.

The role of resilience in involuntary chief nursing officer job loss.

The purpose of this article is to discuss the role resilience plays for chief nursing officers who have experienced involuntary loss of their positions. Various definitions of resilience based on 3 stages of resilience inquiry that have evolved over time and the "Broaden-and-Build Theory" of positive emotions are presented. Based on this foundation, recommendations are presented to help these chief nursing officers develop or enhance their resilience to move forward to a successful future.

Organizational characteristics and patient experiences with hospital care: a survey study of hospital chief patient experience officers.

Beginning in fiscal year 2013, scores based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) constitute 30% of incentive-based payments from Medicare's Value-Based Purchasing (VBP) initiative. Yet there is little empirical work to understand hospital approaches to improving the patient experience. In this study, chief patient experience officers at 416 VHA hospitals were surveyed to assess the relationship between organizational characteristics and publicly reported HCAHPS scores. Of 416 institutions, 143 (34.4%) participated. Respondents reported that boards (68%) and chief executive officers (81%) viewed the patient experience as extremely important. In contrast, they reported that in only 15% and 34% of hospitals, respectively, physicians and nurses were supportive of efforts to improve the patient experience. Hospitals with collaborative cultures and higher physician engagement had higher VBP total HCAHPS scores (6.9 points and 8.2 points higher, respectively; both P < .05). These areas should be addressed to improve the patient experience in provider organizations.