FORCE 1
Quality of Nursing Leadership
Nursing leaders are perceived as
knowledgeable, strong risk-takers who follow
an articulated philosophy in the day-to-day
operations of the nursing department. Nursing
leaders also convey a strong sense of advocacy
and support on behalf of the staff.
EXECUTIVE SUMMARY FORCE 1: QUALITY OF NURSING LEADERSHIP
Nursing leaders are perceived as knowledgeable, strong risk-takers who follow an
articulated philosophy in the day to day operations of the nursing department. Nursing
leaders also convey a strong sense of advocacy and support on behalf of the staff.
Under the visionary leadership of the Senior Vice President for Patient Care Services and
Chief Nurse, The Massachusetts General Hospital (MGH) has created a professional practice
environment that supports growth and development of nursing staff through its excellence in
nursing services. To accomplish this, the Chief Nurse is visible in the highest governing bodies of
the organization strategically situated to influence decisions that impact nursing and patient care
delivery. Committed and talented nursing leadership is also essential to this success. Whether at an
executive or unit-based level, leaders are expected to, “…challenge the process; inspire a shared
vision; enable others to act; model the way; encourage the heart” (Kouzes and Posner), an adopted
philosophy of leadership within Patient Care Services.
The Patient Care Services (PCS) Vision, Guiding Principles, Nursing Philosophy, Strategic
Plan and Professional Practice Model have been carefully designed to be congruent with the
hospital’s four-pronged mission of practice, education, research and community. Members of the
Patient Care Services Executive Team crafted these documents, seeking input from managers and
direct care staff. With this framework, a Patient Care Delivery Model was also articulated ––
interdisciplinary patient- and family-centered care. The nine components of the PCS Professional
Practice Model were revised ten years after its original design to include: vision and values; standards
of practice; narrative culture; professional development; patient-centeredness; clinical recognition
and advancement; collaborative decision-making; research; and innovation and entrepreneurial
teamwork. Collaborative decision-making, operationalized as Collaborative Governance, gives
direct care staff a prominent voice in the organization in decisions that impact their practice and
quality of work-life. The development of the Clinical Recognition Program embodies the MGH
narrative culture and creates opportunities for professional recognition and growth. Examples
provided reflect nurse leader’s ability to successfully articulate patient and staff needs and secure the
appropriate fiscal and human resources.
Retreats with PCS Executive Team, Nursing Directors and members of the Collaborative
Governance Committees were the primary interactive strategy for creating and disseminating
information about the Vision, Guiding Principles, Nursing Philosophy, Professional Practice Model
and Strategic Plan. Patient Care Services and Hospital publications such as Caring Headlines,
Hotline, PCS News You Can Use; as well as Hospital, Departmental and Unit Committees, staff
meetings and conferences broaden the audience and reinforce messages about patient care. The
budget process and resulting reports in combination with the quality dashboard provide vital
operational, clinical, staff and fiscal information for leaders to make informed decisions. Examples
are imbedded throughout the Force.
Enculturation of the values of the organization are most aptly reflected in the
MGH
Patient Care Services evaluation of nurse satisfaction through the Staff Perceptions of the
Professional Practice Environment Survey (SPPPE), administered every 12 - 18 months since 1999.
In 2006, 92% of the nursing staff respondents reported being satisfied or very satisfied with the
professional practice environment at MGH. The high degree of participation in the Collaborative
Governance Committees from within and outside of the Department of Nursing has contributed to
the staff satisfaction and the organization’s success. Decisions about staffing and resources reside at
the unit level, closest to the staff and the patients. Nurses at all levels are committed and engaged in
professional growth and development with nurses at MGH belonging to more than 60 different
professional organizations.
TABLE OF CONTENTS
Volume 1
Force 1: Quality of Nursing Leadership
Sources of Evidence
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
Pages 1-10
Pages 11-28
Pages 29-40
Pages 41-55
Pages 56-69
Pages 70-84
Pages 85-96
Pages 97-149