Vermont Nurse Leadership Fellows Program -
NURSINGNONCREDIT_FELLOWS20140310
Topic
Learning Objectives
Content
Business of
Nursing in
Vermont:
Implications of
Health Reform
on Nursing
Practice
Detail the issues within
healthcare financing
reform
VT Health care reform experience to date
Finance Reform
Financing Federal level – hybrid approach
1. Employee/employer
2. Tax funded – nearly 50% of US HC Medicare,
Medicaid, & Tri-care
Federal finance reform: ACA
Financing reform – State of Vermont
Single payer by 2017
Finance reform does not fix the cost problem
Administrative efficiencies and eliminate waste
Emerging model: volume-driven healthcare moving
towards value-driven healthcare
Nearly 20% of GDO goes to HC in VT, 17% nationally
IOM estimates 1/3 of what we do does not make diff.
Ethics of cost containment
Act 48
Board that changes the way we pay
Publically funded program with universal coverage
Established health benefit exchange
Green Mt. Care Board – focus on payment reform
Payment reform & delivery redesigns
Accountable Care Organizations (ACO)
Bundled payments replace fee for service (FFS)
Reduction of readmission rates nets HC savings
VT Chronic Care Initiative
Pay for Performance (P4P)
Explain the rationale
behind healthcare
innovations
Explore the benefits of
the ACO approach as
part of the VT State
Innovation Model
Delivery Method &
Assignments
Nursing Summit PP
Presentation
Assessment of
Learning
Question and Answer
Discussion
Feedback
Ongoing
Topic
Introductions
Learning Objectives
Content
Analyze the role of
nurses in emerging HC
reforms.
Leadership, practice, policy implications
Nursing pay for performance - need to first
understand the economics of nursing practice, accept
accountability for costs & be aware of incentives
- Buerhaus, 2010, p. 50
Nurses are in pivotal position to drive system changes
ID competencies needed in new roles
Professional development for new functions
Evidence gaps – need to question: Fee for service,
physician centric, & RN challenged by critiquing &
applying evidence
Consolidation brings together entities
Integration eliminates duplication
Learn to speak the
language of economics in
healthcare
Manage system as a whole – ideal for nurse
intervention
New opportunities: Medical Home, Blueprint for
health, ACO & chronic care management.
Nurses on boards for governance, regulation &
advisory
Take leadership role in redesign of processes of care
Connect with colleagues
in developing your
personal plan, objectives
and professional role as a
nurse leader.
Post a brief introduction to yourself in Blackboard
posting.
Decorate your web page as desired.
Modify the press release to submit to local papers.
Press release includes both RWJF and AARPs support
for this work.
Delivery Method &
Assignments
Assessment of
Learning
Blackboard course
participation
Press release for local
publication of Fellowship selection. Use the
blog feature to discuss
and question
Topic
Learning Objectives
Content
Overview
Determine where your
own ‘growth edges’ are
or what foci each Fellow
will find helpful.
From Boards to Body Language
Materials that address “being” vs. “knowing”
Importance of association with affiliated groups
Public speaking -
Leadership:
From Boards to
Body Language
Section One:
Orientation,
overview, and
introduction
Select intelligently from
several different
approaches to
leadership.
Leading the pack:
Review of Leadership Theories
Why Lead – society needs us; most trusted professionals
Hospitals are all about nursing care – as nurses will we
lead, or be the pack horses of the system?
Concept of leadership – mobilizing others to want to
struggle for shared aspirations
Leadership requires followers, collaboration, an aim
Carrying a common goal
Trait-based Leadership
High level leaders apt to be Myers-Briggs NTs
Requires cognitive capacity, dispositional attributes,
motives/values, and problem-solving skills.
Synergy of interaction – metacognition, tolerance for
ambiguity, social intelligence
Creative Leaders (Sternberg, 1999)
Metacognition – thinking about thinking
Poor leaders vacillate between over and under control
Creative leaders are effective at selective encoding and
find intrinsic rewards for what they like to do.
Emotional intelligence, Self-awareness , Self-management
Social awareness & Relationship management
Delivery Method &
Assignments
Reading: Blackboard
course materials and
Primal Leadership
(Goleman, 2013)
Reflect on what you wish
for.
Screencast – Review of
Leadership theories
Podcast with voice over
done in brief snippets plus PP presentation
Assessment of
Learning
Write a set of
objectives and an
action plan that
includes specific
things that are
intended as actions
within the Fellowship.
BB discussion
pertaining to
leadership styles,
readings,
collaboration, etc.
Which leadership style
resonates for you?
Reading: Lean In with
Caution
Who do you want to be,
who are you now, where
do you want to go?
Those things that draw
our attention are
significant components
of who we are and who
we can be.
Make a ‘hero’s
collage’ – Photos of
those who are your
heros and what do
they teach you about
your ideal self.
Topic
Learning Objectives
Content
Delivery Method &
Assignments
Which aspects of
development can guide
the development of your
‘growth edges’?
Assessment of
Learning
Three major categories of boards
1. Regulatory
2. Governing
3. Advisor
Culture, purpose and mission of the organization shape
the board and its duties.
Ways to have Board Access
Read the articles in order
of posting:
Nurses on Boards –
(Hassmiller, 2012)
A different voice: Nursing
on the board - (Meyers,
2008)
Non-profit governing
boards - (Worth, 2013)
The 10 habits of highly
effective boards (Legon,
2014)
Attend at least one board
meeting.
Notes pertaining to
the formal vs.
informal culture of the
board. Who speaks?
Who doesn’t? Who is
listened to? Why
does that happen?
Report experience
back to small work
group, including new
knowledge, new
questions.
Describe previous
board experience with
details of type.
Speaking up – the wisdom to know when to be bold and
when to be subtle.
Speaking needs practice
Observe yourself - related to public speaking
Share tips with others in work group
Review sites for public speaking
More images and less text: The emotional brain
process images and symbols, not words and
numbers
Read: Promoting Health:
Advocacy guide for
health professionals –
International Council of
Nurses
Discussion of
speaking, writing, and
other presentation
modalities.
Boyatis’s Model of Self-Directed Learning (Precey,
Entrana, & Jackson, 2013)
Servant Leadership – service to others rather than to
ourselves
Section Two:
A Primer on
Boards
Review the anatomy of a
board.
Determine the difference
between governing
board in non-profits,
governing board in for
profit, regulatory boards,
and advisory boards.
Section Three:
Growth Edges in
Dissemination
Explore dissemination
methods of speaking,
writing and poster
presentations.
Topic
Learning Objectives
Content
Speaking up!
Develop neuro-pathways
that serve for changing
patterns and expectation
throughout your life.
Neuro networks are formed based on what we habitually
repeat.
Speaking, writing and posters
Writing
Why write?
1. Write
2. Don’t interrupt yourself with editing
3. Understand that no one writes well
4. Read the article: ‘How to write less badly’
5. Know your tactile materials
6. Play with place
7. Sort out your approach
8. Know your weaknesses
9. Read your manuscripts aloud
10. Know when to quit
Posters
Guide for posters – abstracts, create an effective
presentation, poster presentation tips
Is your practice based on evidence?
Describe the policy
process.
Political Influence
Influencing healthcare through state and federal
policy formation
Ways of influence
Lobbyists
How to contact policy makers
Letters, laws and bills of interest
Maintaining the connection
Overcoming impediments to involvement
Effective mentoring
Section Four:
Policy and
Politics
Detail points of influence
in policy formation
Explore the unique
contribution of nurses in
policy formation
Delivery Method &
Assignments
How to write less badly
(Munger, 2010)
Assessment of
Learning
Do something that you
have never done in this
area and make a note of
it to yourself
Reflective journal
pertaining to new
skills attempted.
Readings as linked in BB
Complete Political
Astuteness Inventory
(Clark, 2008)
Blog postings
pertaining to policy
involvement
Do something related to
political influence that
you have never done
before. Share it with
your blog group.
Topic
Learning Objectives
Content
Delivery Method &
Assignments
Assessment of
Learning
How a bill becomes law (Abood, 2007)
Advocacy vs. Lobbying
Expanding your sphere of influence
Vermont
Organization of
Nurse Leaders VONL
Role in 2015
Nursing Summit
Conference
Participate in Nurse
Leadership meetings and
decision-making
(insert agenda headings for VONL meetings)
Meeting participation –
VONL strategic planning
Engage in Nurse
Leadership development
at a state level
Plan for 2015 Nurse Summit Conference
Develop and prepare for
nurse leadership summit
as outlined within
agenda
Agenda for 2015
Nurse Summit with
Fellows participation
and leadership
engagement.
References
Abood, S. (2007). "Influencing Health Care in the Legislative Arena". OJIN: The Online Journal of Issues in Nursing. 12(1) Manuscript 2.
doi: 10.3912/OJIN.Vol12No01Man02
Des Jardin, (2001b). Political involvement in nursing: Education and empowerment. Association of Operating Room Nurses Journal, 74 (4), 468-475.
Des Jardin, K. (2001a). Political involvement in nursing: Politics, ethics, and strategic action. Association of Operating Room Nurses Journal, 74(5), 614-618,
621-622.
Eby, L.(2007). Understanding relational problems in mentoring: A review and proposed investment model, in Ragins, B., and Kran, L. (Eds) The handbook of
mentoring at work: Theory, research, and practice. Thousand Oaks, CA: Sage Publishing
Goleman, D. B. (2013). Primal Leadership: Unleashing the Power of Emotional Intelligence. Harvard Business Press.
Gordon, S. (2005). Nursing against the odds: How health care cost-cutting, medial stereotypes, and medical hubris undermine nursing and patient care.
Ithaca, NY: Cornell University Press.
Hassmiller, S. (2012). Nurses on boards: Competencies required for leadership. American Journal of Nursing, 112(3), 61-66.
Kelly, J., Fealy, G., & Watson, R. (2011) The image of you: constructing nursing identities in YouTube. Journal of Advanced Nursing, 68(8), 1804–1813.doi:
10.1111/j.1365-2648.2011.05872.x
Kets de Vries, M.F.R. (2013) The Dangers of Codependent Mentoring. Harvard Business Review Blog, http://blogs.hbr.org/2013/12/the-dangers-ofcodependent-mentoring/, retrieved June 20, 2014
Legon, R. (2014, Mar/Apr). The 10 habits of highly effective boards. Retrieved 2(22), from Association of Governing Boards of Universities and Colleges:
agb.org/trusteeship/2014/3/10-habits-highly-effective-boards
Meyers, S. (2008). A differenct voice: Nurses on the board. Trustee, 61(6), 10-14.
Munger, M. (2010, October). 10 tips on how to write less badly. Retrieved October 18, 2014, from The Chronicle of Higher Education:
chronicle.com/article/10-Tips-on-How-to-Write-Less/124268/sid=at&utm_source=at&utm_medium=en#top
Precey, R., Entrana, M., & Jackson, C. (2013). Leadership for inclusion. In Leadership for inclusive education (pp. 131-148). SensePublishers.
Pulcini, J. (2014). Interview with a Nursing Policy Leader: A Hopeful Look at a Changing Profession. American Journal of Nursing, 114(1), 19–2, DOI:
10.1097/01.NAJ.0000441785.39914.ea
Sanzero Eller, L., Lev, E., & Feurer, A. (2013). Key components of an effective mentoring relationship: A qualitative study. Nurse Education Today 34, 815820
Summer, S. & Sommers, H.J. (2010). Saving lives: Why the media’s portrayal of nurses puts us all at risk. New York, NY: Kaplin Publishing:
Worth, M. J. (2013). Nonprofit Governing Boards. In M. J. Worth, Nonprofit management: Principles and practice. Sage.