10/7/2014
Being the Change Starts With Us
Leadership Begins with Self‐Leadership
We are the Profession
Raising Up the Next Generation:
Being the Change We Hope to See in Our Profession
Gladys Campbell, RN, MSN, FAAN
CEO, Northwest Organization of Nurse Executives
What is the Best that We Can Be? How then do we make our optimal contribution to our patients?.... To our profession?
How do we Honor the Public’s Trust?
Alex deTocqueville’s Democracy in America
Of All Professions, & Of All
Healthcare Providers, Nursing is
the Most Highly Respected &
Trusted
Peter Hart, 1990
…What is nursing’s unique contribution to patient well‐being?
…What is it that nurses do that no one else does?
…What is it that Nurses do, that if they do not do it, it will not get done?
How have we lost sight of unique contribution?
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10/7/2014
What happened to Nursing when
we became, largely, employees of
hospitals?
The Pecking Order
2. Being a Hospital Systems Expert
1. Practicing Medicine
3. Then if there’s time left over… and if we can
remember… we might practice a little nursing
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10/7/2014
Reclaiming our Nursing Profession:
Its Rich History and Promising Future
Appreciating Our Past • Nursing Leaders
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Florence Nightingale
Clara Barton
Mary Eliza Mahoney
Mary Breckinridge
Margaret Sanger
Hazel Johnson Brown
Virginia Henderson
Dorothea Dix
Lavinia Dock
Mary Adelaide Nutting
Martha Rogers
Dorothea Orem
Hildegard Peplau
Madeline Leininger
Jean Watson
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10/7/2014
Hospital / Acute
Care “Centricity”
and the
Corporate
Practice of
Nursing
The Impact of Rising Healthcare Costs and our need to reduce costs while maintain excellent care and Service What Other Forces Work Against Us As We Try to Make Our Optimal Contribution & Remember the Importance of Our Profession? Social and Economic Costs of Late‐Stage, Late Intervention, High Cost Health Services • Current Healthcare costs = 18% of GDP
• Projection – costs will reach 30% of the GDP by 2025 unless there is a serious transformation toward health
• Healthcare costs are added to all of the products and services sold by the US
• The US is quickly losing its hold as the economic leader of the free world
• In a global economy will not be able to be competitive
Regardless of Political Ideology –
We Need Change
• 50% of all healthcare spending of health spending goes to 6% of the population
• 50% of these people consume these costs in the last 60 days of life
• Limited impact and marginal outcomes with regard to net aggregate health of the nation
• Most of the “health” we experience today, has come from public health interventions 4
10/7/2014
So What Transformational Changes Do We Need to Make?
If Nursing is to remain relevant in a transformed care environment we must be willing to shift our mental models, and lead into the change.
University of Pennsylvania Hospital founded by Benjamin Franklin in 1751
What do you think the
Average LOS was in
1751??
1. Reduce “residential” or bed‐based services and accelerate home‐based, clinic‐based, and community services while promoting the notion that all care providers work to the top of their education, training, and licensure. So What Transformational Changes Do We Need to Make?
1.
Reduce “residential” or bed‐based services 2. Promote full engagement of the public, and individual ownership of health and health care with care providers serving a support role to this engagement. 1.
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Reducing unnecessary C‐Sections
Assuring access to prenatal care
Advancing infant nutrition and pediatric obesity
Reducing childhood stress
Average LOS now – 3.7
days
So What Transformational Changes Do We Need to Make?
So What Transformational Changes Do We Need to Make?
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Reduce “residential” or bed‐based services Promote full engagement of the public ownership of health 3. Shift toward primary care and advance nursing’s role in primary care. 1. Primary care infrastructures will be the centerpiece for early engagement in health
2. Primary care will be centered around populations, episodes of illness, and continuity of care to prevent, avoid, or manage high intensity care and its cost
3. There is significant opportunity to enhance the role of both the nurse midwife and ARNPs in primary care.
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Reduce “residential” or bed‐based services Promote full engagement of the public ownership of health Shift toward primary care and nursing’s role in primary care. 4. Nursing will be needed to manage teams around population care and navigation of that care in a continuous way that efficiently uses resources to achieve outcomes and value.
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10/7/2014
So What Transformational Changes Do We Need to Make?
1.
2.
3.
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Reduce “residential” or bed‐based services Promote full engagement of the public ownership of health Shift toward primary care and nursing’s role in primary care. Nursing will be needed to manage teams around population care and navigation of that care in a continuous way that efficiently uses resources to achieve outcomes and value.
5. Care Delivery will be largely managed through tele‐health and digital technology as the mediums for the assessment, management, and evaluation of health, and to increase clinician availability, portability, and utility.
Beyond the Big Transformational Changes, What Personal Changes Do We Need to Make?
• Understand the difference between your profession and your job…. Predictions
• 90K new primary care providers will be needed
• Medically controlled health care models will be shifted by market forces
• Federally funded support for primary care will require the removal of trade barriers
• Payments will gravitate to Medicare/Medicaid rates
• Electronic data management will force the rapid movement from research to practice – from “knowing” to “doing”
Beyond the Big Transformational Changes, What Personal Changes Do We Need to Make?
• Think Before You Speak… be conscious of the language you use…
– “Eating our young”
– “We need a seat at the table”
– “Moral distress” vs. moral courage
– “Disempowered”
– “Compassion fatigue” vs. compassionate
Beyond the Big Transformational Changes, What Personal Changes Do We Need to Make?
• Consider the power of invitation, reach out to others
• Remember that everyday people are watching you, listening to you, and you are painting a picture of nursing for those people. Beyond the Big Transformational Changes, What Personal Changes Do We Need to Make?
• Practice Self‐Care and Centering: You cannot give kindness to others if you withhold it from yourself. • Be an example for others. Paint the picture that makes others say “that’s who I want to be in my future”
• Consider your legacy – how will others remember you? 6
10/7/2014
Reflect on Nursing’s Unique Contribution to Patient Well‐Being • Simon Sineck
What Makes a
Nation Great?
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10/7/2014
So….
Dare Greatly
Make a Big Ripple
Gladys Campbell, RN, MSN, FAAN
CEO, Northwest Organization of Nurse Executives
206‐216‐2544 (Office)
503‐422‐8236 (Cell)
gladysc@wsha.org
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