American Organization of Nurse Executives Mission: To shape health care through innovative and expert nursing leadership Vision: Global nursing leadership one voice advancing health 1
About AONE The American Organization of Nurse Executives (AONE) is the national professional organization for nurses who design, facilitate and manage care. With more than 8,700 members, AONE is the leading voice of nursing leadership in health care. Since 1967, the organization has provided leadership, professional development, advocacy and research to advance nursing practice and patient care, promote nursing leadership excellence and shape public policy for health care. AONE is a subsidiary of the American Hospital Association (AHA). For more information, visit the AONE website at www.aone.org. 2
Serving Our Members AONE serves its members by: Providing a vision for nursing leadership to meet the health care needs of society. Influencing legislation and public policy related to nursing and patient care issues. Offering member services that support and enhance the management, leadership, educational and professional development of nurse leaders. 3
President Linda Knodel, MHA, MSN, NE-BC CPHQ, FACHE Senior Vice President/Chief Nursing Officer Mercy Chesterfield, Missouri Immediate Past President Michelle Janney, PhD, RN, NEA-BC Senior Vice President and Wood-Prince Family Chief Nurse Executive Northwestern Memorial Hospital Chicago, IL President-Elect Linda Burnes Bolton, DrPH, RN, FAAN Vice President, Nursing and Chief Nursing Officer Cedar Sinai Medical Center Los Angeles, CA Treasurer KT Waxman, DNP, MBA. RN, CNL, CENP Assistant Professor University of San Francisco School of Nursing and Health Professions San Francisco, CA 94117 Secretary Pamela A. Thompson, MS, RN, CENP, FAAN Chief Executive Officer AONE/ SVP for Nursing, American Hospital Association (AHA) Washington, DC AONE 2014 Board of Directors Region 1 Sharon Gale, MSN, RN Chief Executive Officer Organization of Nurse Leaders, Massachusetts-Rhode Island Burlington, MA Region 2 Gail E. Latimer, MSN, RN, FACHE, FAAN Vice President, Chief Nursing Officer Siemens Healthcare 51 Valley Stream Parkway Malvern, PA Region 3 Mary Tonges, PhD, RN, NEA-BC, FAAN Senior Vice President and Chief Nursing Officer The University of North Carolina Hospitals Chapel Hill, NC Region 4 Christopher Martorella, MSN, RN, NEA-BC Consultant & Interim Health Care Leader Ormond Beach, FL Region 5 Mary Beth Kingston, RN, MSN, NEA-BC Executive Vice President, and Chief Nursing Officer Aurora Health Care Milwaukee, Wisconsin Region 6 Karen Wray, MSN, RN-BC, NEA-BC Nursing Director Acute Care Services The University of Kansas Hospital 3901 Rainbow Blvd. Kansas City, KS Region 7 Robert L. Dent, DNP, MBA, RN, NEA-BC, CENP, FACHE Vice President, Patient Care Services/Chief Nursing Officer Midland Memorial Hospital Midland, Texas Region 8 Sharon Pappas, RN, PhD, NEA BC, FAAN Chief Nursing Officer and system Chief Nurse Executive Porter Adventist Hospital and Centura Health Denver, CO Region 9 Patricia Cochrell, RN, MBA, NE-BC Past Senior Vice President, Quality, Operations and Chief Nursing Officer Harrison Medical Center Bremerton, Washington Member-at-Large Elaine Cohen, EdD, RN, FAAN Associate Chief Nursing Quality Improvement The James A. Haley Veterans Hospital Tampa, FL 4
AONE 2014 Appointed Board of Directors Erik Martin, MSN, RN, CNML Pediatric Intensive Care Unit Cincinnati Children s Hospital Cincinnati, OH Claire Zangerle, RN, MSN, MBA President and Chief Executive Officer Visiting Nurse Association of Ohio Cleveland, Ohio Adriana Perez, PhD, ANP-BC Assistant Professor & Southwest Borderlands Scholar Co-Director, Hartford Center of Gerontological Nursing Excellence Arizona State University College of Nursing and Health Innovation Phoenix, AZ Reynaldo R. Rivera, DNP, RN, NEA-BC, FAAN Director of Professional Nursing Practice Innovations New York-Presbyterian Hospital New York, NY 5
VALUE, A Nursing Outcome National Student Nurses Association November 6, 2014 Sharon Pappas, PhD, RN, NEA BC, FAAN CNO, Porter Adventist Hospital CNE, Centura Health AONE Board Region 8 6
Our Cost Our Contribution 7
Background Evidence 2006 Nurse Staffing/Cost Study Strongest predictor of costs was Adverse Events (AE) Strongest predictor of AE was patient characteristics Dr. Porter-O Grady focus beyond the activity of nurses to include the patient impact of nursing care. 8
Background Evidence Length of stay Readmissions Hospital acquired infections Failure to rescue Falls Post op pneumonia Patient satisfaction BUT, just giving a nurse fewer patients doesn t guarantee better outcomes. 9
VALUE ~ Confluence of Outcome Effectiveness, Service and Cost Quality Outcomes Patient level Value Service Surveys Convenience Cost Not charges Patient level 10
Cost Measurement INPUT Cost of a Nurse OUTPUT Cost per Case 11
Return on Investment Adequate Numbers Investment Investment Essential Knowledge Accountability Culture/EBP Improved Quality Lower Costs Return 12
Implications for Nursing #1 The concerns about the cost of nurses and nursing structures are top of mind, and executives are hungry for evidence on the financial return on these structures. p. 126 13
Implications for Nursing #2 Bundled Payment Hospital Surgeon Anesthesiologist Pathologist Post Acute Care 14
Implications for Nursing
Implications for Nursing
Implications for Nursing
Implications for Nursing
Implications for Nursing
Implications for Nursing #7 Financial metrics must be reported and accepted by nurses as their responsibility.
Implications for Nursing #7 Financial metrics must be reported and accepted by nurses as their responsibility.
Cost Impact of Nursing Work INPUT Cost of a Nurse $60,000 OUTPUT Cost per Case -$461,000
What would nursing leaders advise Never stop learning Nursing is full o f so many unique roles experience it Belong to a professional organization Be a mentor Advance you education Seize the day Nursing is not a job but a profession
Nursing is both an art and a science, a health profession and a calling, a set of skills and a distinct body of knowledge, and to all of us, a sacred mission.
Leadership eal leadership starts from a proposition that you do not seek or accept a eadership designation because it pays better or because you get more ecognition, but because you hunger for e responsibility of making a difference. Dr. Jack Cochran The Doctor Crisis
Iwould love to answer your questions and hear your feedback on this innovation.
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