The landmark Institute of Medicine Report on the Future of Nursing recommended that nurses be prepared and enabled to lead change and advance health.1 This month, I am going to shine the spotlight on the exceptional work being done through the Nurse Leadership Academy (NLA), a collaborative initiative of the Wisconsin Organization of Nurse Executives (WONE), the Wisconsin Nurses Association (WNA), and the Wisconsin Center for Nursing (WCN).
In 2008, the Board of the WONE included plans for an NLA in its strategic plan as a means of bringing the organization's mission to develop future leaders to life. A collaborative planning committee was formed and included members from WONE, WNA, and WCN. The committee engaged in brainstorming the curriculum components with colleagues from academia. With a grant from the Robert Wood Johnson Foundation, the curriculum was developed, and the 1st Academy was launched in 2009. Since the initial offering, the Academy has evolved into a semiannual event, with the location moving across the 4 quadrants of the state. Each Academy draws an average of 40 to 50 participants from a wide array of practice settings.
I had an opportunity to participate in the September 2013 Academy in Green Bay, Wisconsin, as a facilitator and to interview Paula Hafeman, RN, MSN, FACHE, vice president and chief nursing officer of the Hospital Sisters Health System hospitals in Green Bay and Sheboygan and current chair of the NLA. Through 1st hand observation and the benefit of Paula's history with the Academy, I concluded that this is an approach worthy of replication and dissemination throughout the country.
The structure of the academy is unique and effective. It uses a number of teaching strategies to enable participants to optimize their learning. These include the following:
* A leadership assessment that is completed by Academy participants and their managers before the in-person learning sessions. The assessment serves as a mechanism to both highlight strengths and identify areas for future development. This information is incorporated into the action planning that each Academy participant engages in.
* Support of 2 days of off-site time, during which participants attend didactic presentations and have opportunities to apply content though small-group work. Participants are assigned to tables with individuals they are unlikely to know to facilitate cross-pollination of thought and ideas.
The course content is presented by volunteer faculty, who are members of WONE and WCN, and includes the following:
* Enhancing leadership/self as leader
* Principles of communication
* High-reliability organizations: quality, safety, and evidence-based leadership
* Generational gifts/diversity
* Strategic planning/systems thinking for nursing leaders
* Creating a healthy practice environment
* Leading teams through change
Course content is continually evaluated to ensure that it is fresh, current, and responsive to the learning needs of emerging leaders. The evaluations from the participants themselves serve as a rich source of content enhancements. For example, the content that addresses generational gifts was added when participants identified this as a need. Similarly, the leadership of the Academy aligns its educational priorities with emerging issues from American Organization of Nurse Executives. As an example, concepts related to innovation have been incorporated into the course content as AONE began to highlight this important leadership area.
* A project is undertaken by each participant as a means of integrating and applying what has been learned in the real practice setting. Participants work with a mentor, both in the completion of their project and for some number of months that follow, as they continue to work on the development of leadership skill. The duration of the mentoring relationship is not prescribed. It is determined by the individuals involved. The participants of the Academy reconvene for a 1-day session several months after the initial 2 days off-site to present their project to their colleagues.
My interview with Paula Hafeman, Academy chair, illuminated a number of noteworthy program elements:
* The effort to pair emerging leaders with mentors creates an opportunity for long-term, collegial relationships. The WONE has recruited members willing to serve as mentors to new leaders and posted their vitae on the WONE Web site.
* The Academy is open to nurses who are new to management or who are direct care nurses interested in developing their leadership skill. This creates the conditions for leaders to emerge from various roles throughout the discipline and recognizes that clinical leaders will be increasingly important as healthcare evolves.
* Participants from all practice settings are welcome. The course that I had the opportunity to witness had representatives from ambulatory settings as diverse as a Native American Clinic and the Corrections system, as well as acute care. There was also an excellent mix of ethnic and gender diversity.
* The mobility of the course to different settings throughout the state creates convenient access for participants.
* The fee for the course, which is $200 if the leader who sponsored the participant is a WONE member and $400 if the leader is not, is used to fund 5 annual scholarships, in the amount of $1,000 each, to WONE members who are pursuing their bachelor of science in nursing, master's of science in nursing, or doctorate degree. To maximize the funds available for scholarships, the host hospital for each Academy session contributes the materials and meals, in addition to the space.
The perspective of a former Academy participant was provided through an interview with Amy Broihahn, RN, MSN, director of a surgical intermediate unit in an acute care hospital. In 2011, Amy accepted the position of director. She had been a direct care nurse on her unit and had previously had significant management experience in business settings, although none in nursing. She explained that she quickly realized that there were significant differences in the settings and roles. She was eager to pursue additional skill acquisition. Specific areas of content from the Academy that Amy found helpful were outcomes management, evidence-based practice, quality and safety, strategic management, and systems thinking. She also felt that there was great benefit derived from hearing course presenters speak of their own career progression and networking with young leaders from across the state, relationships that she has since maintained.
Amy's project serves as an excellent illustration of the caliber of work being produced. She sought to imbed more objective information into the employee performance review process, which she believed contained too many unsubstantiated, subjective observations from managers. She incorporated scanning percentages from the barcode medication administration process, number of overtime shifts worked, staff meeting attendance, and elective developmental activities, as examples. These provided the foundation for her conversations with her employees, such as patient safety, unit fiscal goals, and professional engagement. This work was so well received among her peers that Amy created a PowerPoint for the entire nursing leadership team, whose members also adopted this approach.
Our Wisconsin colleagues are to be commended as they role model a great collaborative effort to prepare and enable nurses to lead change and advance health. On Wisconsin!
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