1. Hader, Richard RN, CNA, CHE, CPHQ, PhD, FAAN, Editor-in-Chief

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Nurses tackle countless responsibilities on a daily basis. Physical assessments, care planning, medication administration, teaching, and meeting complex patient needs are just a few. Not only is the nursing staff busy, but our healthcare service and professional colleagues are occupied as well. Frequently it appears as though everyone is working hard doing his or her own thing, but the team isn't functioning in synchrony. Everyone has rival objectives and competing initiatives. Ultimately, these differences cause habitually harmful competition among healthcare providers.

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Because of this antagonistic culture, many feel as though they accomplish little due to the lack of a clear and congruent understanding among providers regarding the mission of the organization. What was the purpose for the day? Did staff members help to contribute to the achievement of the goal and the vision of the organization, or were they just completing tasks and going home frustrated, overworked, and devalued? Can staff members articulate how their work helped to meet the overall aim of the organization? How can you, as a leader, instill a sense of achievement by relating to them how their work has contributed to the community's health?


A mission statement needs to be more than just words on a piece of paper that's dusted off when a regulatory agency comes to survey. It needs to be a managerial and staff commitment that's developed by your organization's leaders following an exhaustive dialogue between all levels of the organization. Board members, medical staff leaders, department managers, and team members all need to be participants in identifying the strengths and limitations of your organization to clearly formulate its purpose. A mission statement should provide a realistic and attainable foundation for which the strategic plan, performance improvement activities, goal formation, and team alignment are built upon. A poorly constructed and communicated mission statement will lead to staff, physician, and leadership disengagement, and hamper the achievement of organizational objectives. Consequently, it will jeopardize the long-term success and sustainability of your institution.


Once the mission is formulated, educate staff members regarding the direction and goals of your institution. Take an active role in communicating the path of the organization using language that resonates with them. Most clinicians enter healthcare to help others achieve or sustain wellness. It's incumbent upon us to ensure that the mission is consistent with the values of those who complete the work.


When the organization's mission is in line with staff values, the base on which to build a winning culture is strong. You can achieve a positive work environment if there's a consistent and clear alignment between the mission of the organization, the actions of leaders, and the performance of the individual staff member. For example, if the mission of your organization is to improve the health of the communities in which it serves, you're bound to provide the economic and human resources needed to provide that service. Additionally, hold the staff accountable and responsible for providing a level of care and service needed to achieve this goal.


The department manager and senior leaders are integral to realizing the mission of the organization. Make it come alive through active participation in its formation, role modeling appropriate behaviors, and holding your staff accountable to the highest care standards.



"The performance improvement decision" by Sarah Jo Brown, RN, PhD, appearing in the April issue on pages 16-17, is an abridged version of the original article. To view the complete text, titled "Performance improvement: EBP, QI, or EB-QI?" visit


Richard Hader