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.

Gender Differences in Hospital CEO Compensation: A National Investigation of Not-for-Profit Hospitals.

Gender pay equity is a desirable social value and an important strategy to fill every organizational stratum with gender-diverse talent to fulfill an organization's goals and mission. This study used national, large-sample data to examine gender difference in CEO compensation among not-for-profit hospitals. Results showed the average unadjusted annual compensation for female CEOs in 2009 was $425,085 compared with $581,121 for male CEOs. With few exceptions, the difference existed across all types of not-for-profit hospitals. After controlling for hospital- and area-level characteristics, female CEOs of not-for-profit hospitals earned 22.6% less than male CEOs of not-for-profit hospitals. This translates into an earnings differential of $132,652 associated with gender. Explanations and implications of the results are discussed.

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.

Closing the Gap and Raising the Bar: Assessing Board Competency in Quality and Safety.

BACKGROUND: Despite recognition of the important role that governance and executive leaders play in ensuring patient safety and quality, little research has examined leaders' involvement in these areas beyond surveys that assess higher-level knowledge and understanding of patient and workforce safety concepts. METHODS: A survey was sent to a convenience sample of board members and CEOs, as well as unpaired safety and quality leaders (SQLs). The survey included approximately 36 questions asking board members and other non-CEO executives their knowledge, understanding, and board activities related to safety and quality, and SQLs their perceptions of their own boards' knowledge, understanding, and activities related to safety and quality. An analysis of the responses of each of the three groups was conducted to assess baseline ratings, as well as to examine similarities and differences. RESULTS: Overall, similar patterns of self-reported knowledge, understanding, and activities related to safety and quality were evident between the board and CEO groups across virtually all areas examined in this survey, although groups were unpaired. Differences of varying degree were found at the level of individual survey items between board members' and CEOs' responses. SQL ratings were generally lower than the ratings of both board members and CEOs. CONCLUSION: This survey reveals specific areas of focus for improving governance and leadership practices at board meetings, as well as several areas where knowledge and understanding of safety and quality were variable. Further research and consensus would be beneficial to identify best practices for board education and governance activities to drive quality and safety.

A Trend Analysis of Succession Planning in Health Care as Perceived by Chief Executive Officers in US Hospitals.

A study was conducted to analyze the perceptions of chief executive officers in US hospitals regarding leadership development and succession planning. Results of the study were compared to identical surveys delivered in previous years for the purposes of identifying possible trends and changing perspectives related to how executives use succession planning in their facilities, what factors influence the identification of successors, what positions are the more likely to use succession planning efforts, and who specifically should be responsible for building the leadership pipeline.

'Don't wait, look for opportunities'.

Steve Jamieson qualified as a nurse in 1986, and worked for the RCN for 17 years. He was deputy director of nursing, managing a team of professional leads across all areas of nursing, then chief executive of The Hospice of St Francis Berkhamsted.

Cues-to-Action in Initiating Lesbian, Gay, Bisexual, and Transgender-Related Policies Among Magnet Hospital Chief Nursing Officers: A Demographic Assessment.

This study explored Magnet Chief Nursing Officers' cues-to-action initiating lesbian, gay, bisexual, or transgender (LGBT)-specific policies. Homonegativity has a negative effect on employee recruitment and retention and patient satisfaction. Little has been known about what cues-to-action might initiate LGBT inclusive training. Surveys were mailed to 343 Chief Nursing Officers. Cues-to-action survey was used to assess what inspires initiation of LGBT training. Demographic surveys were used to assess what impact variables might have on cues-to-action. Age, sex, religiosity, location, and region had significant effect on cues-to-action. Developing demographically informed training and policies for LGBT equality in health care is suggestive of greater employee and patient satisfaction.

Governance practices and performance in US academic medical centers.

Recognition of the complex nature of modern health care delivery has led to interest in investigating the ways in which various factors, including governance structures and practices, influence health care quality. In this study, the chief executive officers (CEOs) of US academic medical centers were surveyed to elicit their perceptions of board structures, activities, and attitudes reflecting 6 widely identified governance best practices; the relationship between use of these practices and organizational performance, based on the University HealthSystem Consortium's Quality & Accountability rankings, was assessed. High-performing hospitals showed greater use of all 6 practices, but the strongest evidence supported a focus on board member education and development, the rigorous use of performance measures to guide quality improvement, and systematic board self-assessment processes. All hospitals, even those with the highest quality ratings, had major gaps in their use of best practices for CEO and board assessments. These findings can serve as the basis for developing sound board improvement plans.

Succession planning: trends regarding the perspectives of Chief Executive Officers in US hospitals.

A study was conducted to revisit the perceptions of chief executive officers in US hospitals regarding the origin of leadership and how they felt about internally developed successors versus externally recruited successors. Furthermore, the study sought to develop understanding of how this group of executives utilizes the succession planning process, what factors impact successor identification, what positions are applicable for succession planning activities, and who is ultimately held responsible for leadership continuity within the hospital industry. The results of this 2012 study were compared with a previous study conducted in 2007 to determine if the perceptions had changed over time.

The orthopaedist's role in healthcare system governance.

BACKGROUND: Historically, physicians as participants in healthcare governance were shunned because of perceived potential for conflict of interest. This maxim is being revisited as health systems begin to appreciate the value presented by physician leaders. QUESTIONS/PURPOSES: This overview of the orthopaedist's role in healthcare governance will be addressed in three sections: first to identify the need for change in American healthcare, second to examine the role that physicians should play in governing over this inevitable change, and third to outline strategies for effective participation for those physicians wishing to play a role in healthcare governance. METHODS: The PubMed data set was queried applying the search commands "governance AND (healthcare OR hospital) AND (doctor OR physician OR surgeon)" for the time period 1969 to 2012. In addition, the bibliographies of relevant articles were reviewed. This search strategy returned 404 titles. Abstract and article review identified 19 relevant to the topic. Bibliographic review identified five more articles of relevance forming the foundation for this review. RESULTS: The delivery of American health care will require change to face current economic realities. Organizations that embrace this change guided by the insight of physician governors are well positioned to recognize the simultaneous improvement in value and quality. Although few physicians are formally trained for these roles, multiple paths to becoming effective governors are available. CONCLUSIONS: In this environment of rapid change in healthcare delivery, the medical insight of physician leadership will prove invaluable. Governing bodies should reach out to talented physicians and administratively talented physicians should rise to this challenge.

Transforming nursing leadership roles: from CNO to CEO.

Future chief executive officers (CEOs) in health care may very well be required to have clinical backgrounds. Nurses are in an excellent position to lead hospitals and health care systems through impending sea changes. Moving from the chief nursing officer to the CEO requires core leadership competencies and a framework to ensure success. This framework needs to include a self-assessment and a personal development plan. Lessons learned offered to aspiring CEOs include insights and tools to make getting to the top achievable.

Nursing leadership... from the board room to the bedside.

Nurses running hospitals is not new. Florence Nightingale could be considered the first hospital administrator. What is changing is the growth of RN chief executive officers (CEOs), from 10% in 2004 to 18% in 2010. Furthermore, nearly 20% of chief nursing officers (CNOs) aspire to be CEOs. Is this a natural growth of CNO to vice president of patient care services to chief operating officer...to RN CEO? The research on RN CEOs is very small. Therefore, the author set out to obtain a journalistic snapshot of Arizona's 12 hospital RN CEOs through interviews. Of the 12, 3 were corporate CEOs at the system level, they saw over several hospitals, and 9 were CEOs over 1 to 2 hospitals. This article discusses some of the finding from these interviews.

A journey of leadership: from bedside nurse to chief executive officer.

Understanding leadership from the inside out was a journey that spanned a 40-year career in health care. This article describes an individual's journey of becoming an effective executive leader using the LEADS in a caring environment--capabilities framework. This framework was recently developed in Canada and is now used broadly to understand the complexity and depth of health care leadership skills and challenges. The author utilizes the framework to explore leadership skill development from a personal perspective to a broader system transformation level. Challenges and successes along this journey are included to highlight the manner in which leadership evolves with experience, time, and determination. A retrospective view of a successful career in health care provides the model for others to consider a similar career path using a theoretical base and a thoughtful process of personal development.