1. Hader, Richard PhD, NE-BC, RN, CHE, CPHQ, FAAN

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January brings with it the start of a new year and the opportunity for nurse leaders and their staff members to establish goals for the next 12 months. But before developing new targets, it's necessary to reflect on prior achievements and missed opportunities. It's difficult to set forth the direction in which you want to lead your organization without first evaluating the current state of your area of responsibility.


First, evaluate your accomplishments based on internal and external factors that either stimulated success or stalled achievement. For instance, if you weren't able to reach financial targets, it's imperative to critically evaluate factors that contributed to the outcome. Was volume down, yielding less revenue (external factor), or were salaried expenses over budget because a significant amount of your staff members were on medical leave, causing an over expenditure (internal factor)? Should you have anticipated these factors or were they unexpected? Then, analyze current conditions. In developing 2010 goals, you must consider external factors such as the state of the economy and healthcare reform. To ascertain if a goal is worth pursuing, you also need to look at internal factors such as your organization's infrastructure, financial health, and commitment from governance structures and senior leadership.


Clearly define the purpose for achieving a goal and avail the resources necessary to obtain desired results. By providing appropriate leadership, you enhance the commitment of your team to reaching the goal. If the majority of your staff members feel the rationale for achievement is worthwhile, they'll work together as a team to facilitate success. If there's no buy in, goal attainment will certainly fail.


Develop high-stretch goals to stimulate innovation and creativity and cultivate an environment of pursuing excellence. These goals can only be obtained if everyone on the team understands the importance of achieving the target. Establishing goals that are too easily reached will limit performance potential, leading to mediocre results. Avoid developing goal statements that are narrowly defined; broadly articulated goals enhance the opportunity for further development. Include specific milestones when developing objectives, and closely monitor and evaluate the objectives on a frequent basis.

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Don't construe it as a failure when goals aren't attained, rather as an opportunity to critically evaluate how the work will be done differently in the coming year in an effort to avoid similar pitfalls. If your patient fall rate wasn't at target, it's an opportunity to research best practices that have resulted in positive outcomes. If you and your team aren't satisfied with the information provided within the literature, it's an opportunity to develop a unit-based research project to determine what factors are contributing to a high patient fall rate. Developing an original evidence-based protocol will not only help you achieve your department's goal of lowering patient fall rates, but it will also simultaneously contribute to efforts to improve nursing practice.


Goal setting brings new inspiration to the work environment. Remember, goals are the blueprint for achieving the next level of excellence.


Richard Hader

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