Carol Boston-Fleischhauer is a Managing Director and Chief Nursing Officer at the Advisory Board Company, a membership-based research, technology, and consulting firm serving more than 4,400 leading hospitals and health systems as well as a growing international membership base. In this capacity, she serves as a global spokesperson for the firm's research at key membership constituency forums, including clinical and operational leadership, human resources, and quality. She is also responsible for presenting this research to member organizations throughout the United States and abroad. Ms. Boston-Fleischhauer has over 30 years of progressive healthcare experience in patient care practice, operations, management, education and consultation in academic medical centers, community hospitals and clinics, multihospital organizations, and integrated healthcare systems. Her most recent leadership position prior to joining the Advisory Board was that of systems director, quality improvement for a multihospital system in the Pacific Northwest. Other prior positions have included senior leadership roles for various healthcare consulting firms and executive director of the American Organization of Nurse Executives, a subsidiary of the American Hospital Association. Ms. Boston-Fleischhauer's areas of expertise include clinical operations and care model redesign, quality improvement, human resources, and strategic planning.
1. What are the significant professional milestones in your career journey?
CB-F: Over my 40 years of practice; several milestones come to mind that shaped my career journey. First, was an early opportunity to "teach" nursing; I was on the faculty of a few diploma schools of nursing in the 80s; which definitely cultivated my appetite for nursing education. So, early on, I was exposed to opportunities to make a difference with my nurse colleagues. Second was acceptance of an entry-level policy position at the American Hospital Association, which ultimately evolved into being appointed the Executive Director of the American Organization of Nurse Executives. These two opportunities exposed me to nursing practice and healthcare industry issues beyond the "four walls" of an individual hospital-to that of a national perspective. Without question, I credit those opportunities with shaping my belief that all nurses need to be current on national market, legal, finance, and regulatory trends, given that nurses and nursing are being turned to for solutions to the national healthcare reform debate. Further, I learned the power of advocacy for the perspective of nursing as fundamental to any and all policy considerations regarding care delivery priorities and strategies. Finally, in my current role as Managing Director and Chief Nursing Officer of the Advisory Board, I have had the opportunity to work with nursing leadership teams around the world. Global solutions to challenges that domestic nursing leadership teams face has expanded my perspective regarding creative approaches to universal challenges impacting nursing practice. Said differently, the United States does not have all the answers; we can both share and learn from our international nurse colleagues.
2. How have you seen the specialty of nursing professional development (NPD) grow/evolve/change during your career?
CB-F: Great question. Nursing professional development is evolving from a narrow focus on "skills" to that of strategy. Sure, practitioners at all levels of an organization must demonstrate the requisite skills and competencies core to the job, both technical and behavioral. Equally important, however, is the need for professional development opportunities that stretch the practitioner into broader opportunities of influence, change, and practice innovation. A professional development program for any organization or system must include attention to the immediate job needs of the practitioner as well as the practitioner's long-term career development goals. Failure of a professional development program to focus on career advancement as well as immediate job mastery is short-sighted in today's highly competitive labor market that is challenged to both recruit and retain top talent.
3. From your perceptive, what do you see as significant trends or gaps in nursing practice that NPD could address?
CB-F: Key trends in nursing practice that NPD must respond to are workforce readiness for a cross-continuum care delivery model as well as workforce "nimbleness" regarding change and practice innovation. And I am referring here to the range of practitioners: from the frontline or point of care to senior leadership positions. Our complex practice environment, financial pressures, consumer demands, and workforce shortages require skill and courage in terms of experimenting with new ways to deliver cost-effective and efficient care across the continuum versus resisting new options in favor of legacy approaches.
The other major trend that NPD must focus on is what the Advisory Board calls the "RN experience care complexity gap." What I mean by that is this: We have more novice nurses in our workforce than tenured; and with retirements continuing, this trend will accelerate at a time when care complexity is increasing. How do we carefully but principally expedite the development of our novice nurses into competent practitioners, and how do we ensure that our experienced nurses have the skills to teach, coach, mentor, and support their younger peers?
4. What insights can you share related to the value of the NPD in healthcare organizations now and in the future?
CB-F: Professional development for nurses at all levels in an organization cannot be viewed as an optional investment, but rather core to both the support of the professionals themselves as well as the readiness of the nursing enterprise as a whole to achieve the quality, safety, patient experience, and financial outcomes that will be required. Every nurse should have a professional development plan; the NPD strategy must ensure responsiveness to both the needs of the practitioner as well as the needs of the organization within which the practitioner practices[horizontal ellipsis].
5. What advice do you have for the NPD practitioners in the context of today's health care and learning environment?
CB-F: Stay VERY current on market, legal, regulatory, and reimbursement changes in the healthcare industry, both at the national level as well as what is happening locally. NPD practitioners will be viewed as irrelevant to an organization if the NPD program is not tightly aligned with developing practitioners to be successful in a value-based, outcome-oriented healthcare world.
6. Other comments you would like to share.
CB-F: As an NPD practitioner, you must ask yourself the question: How am I providing value to the nursing enterprise that I am a part of? My guidance is to ensure that you are contributing to the professional development needs of nursing professionals in order to both advance their growth as nursing professionals as well as ensure their professional development will solidly position the nursing enterprise to support where the organization is going.