Calling the Shots: Nursing News and Notes

Promote Clinical Care by Embracing a Financial Outlook

Promote Clinical Care by Embracing a Financial Outlook

Tuesday, December 16, 2014
Integrating the financial and clinical demands of their role is one way nurse executives can find balance.

Let’s be honest. A passion to keep an organization’s books in the black isn’t what calls most into the nursing profession. Instead, nurses tend to be drawn to the field by a desire to help people, provide care to the sick and hurting, and make a real difference in individual lives.

For idealists, that’s what it’s all about.

But if a nurse works up the hospital ranks into nurse manager, director, and chief-level positions, the ideals that once inspired nursing practice must increasingly be weighed against the financial realities of today’s healthcare environment.

It’s all in a nurse executive’s role.

Nurse leaders are charged with balancing a hospital’s clinical needs with its financial. Without that balance, the hospital could slip into financial turmoil—and the nurse executive, into emotional turmoil. A 2010 study in Nursing Administration Quarterly of 380 nurse executives found a link between role conflict in their jobs and depression.

No one ever got into the profession wanting that.

Kick Conflict to the Curb

Perhaps the best way for nurse leaders to deal with the financial and clinical demands of their role is to forget about balancing them. Instead, integrate them.

Kathy Douglas, MHA, RN, president of the Institute for Staffing Excellence and Innovation, Sedona, AZ, shared how nursing leaders at Northwestern Memorial Hospital in Chicago saved nearly $5 million in productivity costs while increasing staff satisfaction and reducing nurse turnover to the tune of an additional $7.6 million by embracing the financial aspect of nursing care.

What was their secret?

They Learned.

When Michelle Janney, PhD, RN, NEA-BC, senior vice president and chief nurse executive, wanted to better understand how to use data in clinical decision-making, she hired a non-nurse analyst who could help her interpret data. Having a data expert in the nursing department was invaluable for identifying predicaments, stabilizing them, and finding opportunities for improvement.

She also made sure nurse managers received some education in finance and budgets to help them with decision-making in their units.

Having a non-nurse data expert in nursing’s realm provided insight the department had been lacking.

They Filtered.

Nurse leaders learned the language of finance. In doing so, they abandoned emotional exchanges and “because it is important!” rationales when discussing clinical practice. Instead, conversations became data-driven and addressed patient safety and quality alongside efficiency and cost.

In addition, the nursing department collaborated with the financial department and educated outsiders on delivery-of-care concepts, such as the meaning of “intensity of care” and the value in BSN-prepared hires.

They Flourished.

In realizing their success, the nurse leaders at Northwestern Memorial Hospital didn’t abandon their focus on clinical care. They promoted it all along, supporting it through data-driven rationale.

Anyone discouraged or depressed over fighting the good fight for patient care might learn from their example. 

As Douglas muses, “One cannot help but imagine what the financial and operational picture of healthcare across the country would look like if situations like the one created by Dr. Janney and her team at Northwestern became the rule rather than the exception. How would our conversations change? How would nursing change?”

 

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