HRSA Frontline Leadership Project

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HRSA Frontline Leadership Project

• Karren Kowalski, PhD, RN, FAAN
• And
• Colleen Casper, MS, RN, CTA
• Colorado Center for Nursing Excellence

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Review of Learnings from HRSA I

• 100 Turnover of Nurse Managers within the
  first 15 months
• 75 Turnover of CNOs within the first 30 months
  of grant
• Making any change is all about Leadership

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Grant Objectives

• 1. Increase the skill set for a minimum of 40
  frontline leader/managers as reflected in the
  Nurse Manager Leadership Collaborative Learning
  Domain Framework.
• 2. Educate and support a minimum of 40 coaches
  to provide the frontline leaders with coaching
  support that will assist their behavioral changes
  and their use of acquired skills.
• 3. Increase frontline leader/manager retention
  in the participant population by 50 each year of
  the project.

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• 4. Increase staff nurse retention on the units
  supervised by project participants by 15 each
  project year.
• 5. Nursing units whose frontline leaders are
  participants will demonstrate a 10 increase in
  productivity measured by productive hours per
  patient day.
• 6. Increase patient satisfaction scores by 10
  on the units supervised by project frontline
  leaders.

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Colorado Workforce Survey

• 11,000 registered nurses responded
• 628 Nurse Managers/Head Nurses
• 14 Diploma graduates
• 35 ADN
• 39 BSN
• 12 MS or higher

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Additional Data

• 30 were in these positions lt 24 months
• 45 were uncertain re staying in leadership
• 50 do not demonstrate commitment to stay in
  leadership

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THE FRONTLINE LEADER PROFILE

• Thus emerges a profile of unprepared,
  inexperienced and uncertain frontline leaders who
  according to the literature are the very nurses
  who have a tremendous influence on whether their
  own staff will remain in their jobs.

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Managing the Business

• Financial Management
• Human Resource Management
• Performance Improvement
• Foundational Thinking Skills
• Technology
• Strategic Management
• Appropriate Clinical Practice Knowledge

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Art of Leadership Leading People

• Human Resource Leadership Skills
• Relationship Management and Influencing Behaviors
• Diversity
• Shared Decision Making

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The Leader Within

• Personal and Professional Accountability
• Career Planning
• Personal Journey Disciplines
• Reflective Practice Reference Behaviors/Tenants

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Leadership Course

• Developed in a collaborative manner
• 32 hour, 4 day course
• 10 different teaching faculty
• Threads that drive the process
• Highly interactive
• Faculty are the most engaging / highly qualified
• Utilization of best practices in educational
  theory / adult learning

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Leadership Course

• Enrollment capped at 40 / session
• All students must attend all sessions
• Obligation to utilize the training
• Utilize highly interactive modalities
• Games i.e. Survival game
• Group exercises
• Demonstrations
• Heavy use of scenarios
• Role playing

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Leadership Course (cont.)

• Capstone Project
• Must have a Coach
• Reflective practice / logbooks
• Encourage Frontline leaders to further their
  education

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Curriculum Committee

• Philosophy
• We are preparing the NEXT GENERATION of Nursing
  Leaders
• at the entry level

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Leadership Workshop

• Day 1
• Introductions
• Debrief of LPI
• DISC
• Emotional Intelligence
• Self Care
• Self Reflection
• Acknowledgement

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Leadership Workshop

• Day 2
• Thoughts/ reflections
• Relationship Compassion from EI
• Communication Introduce Toolbox
• Powerful Questions
• Tough Questions
• Appreciate Inquiry
• Horizontal Violence
• Setting Boundaries
• Difficult conversations and Crucial
  Confrontation

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Leadership Workshop

• DAY 3
• Thoughts/ Reflections
• Cultural Diversity
• Creating a positive work environment
• Values, Priority Setting delegation
• Negotiation
• Team Building

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Leadership Workshop

• DAY 4
• Reflections/ Questions
• Coaching
• Change
• Transformational Leadership
• Leader Behaviors and Characteristics
• Capstone Project/ Ending

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Coaching
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The Foundation

• Building a Relationship
• Setting realistic expectations
• Observing Behavior (either first hand or through
  reflection of coachee)
• Devoting time for self reflection on the part of
  the coach to determine most effective approaches
  for this coachee.

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The Learning Process

• The coach is 100 present with the coachee
• Being purposeful with positive intentions for the
  coachee
• Asking thought provoking questions
• Actively Listening to the coachee
• Sharing perceptions openly with no criticism

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Taking Action

• Soliciting and suggesting options
• Requesting specific behavioral changes by the
  coachee
• Clarify the plan for follow up
• Offer support and unconditional positive regard

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Collecting Data

• Janet Houser
• Evidence
• Data on the frontline leaders
• Data on the coaches
• Data from staff and patients
• Data from the hospital

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Selection of 360 Feedback Participants

• They need to complete the inventory
• They need to choose
• Supervisor
• 3 peers
• 3 staff (direct reports)

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CPQ

• COACHING
• PROCESS
• QUESTIONNAIRE

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Questions?