AIM To explore the current evidence on business acumen of nurse leaders. BACKGROUND Health system... more AIM To explore the current evidence on business acumen of nurse leaders. BACKGROUND Health systems across the world are under immense pressure to stay solvent, maintaining services within a defined budget as we recover from the COVID-19 pandemic. Effective nurse leaders not only need to have strong leadership and management skills, but also strong business acumen to navigate the complexity of the system. EVALUATION A scoping review of research was undertaken, using PRISMA scoping extension checklist, with 571 studies found across multiple databases, 17 meeting final review eligibility. KEY ISSUES Findings were noted surrounding three themes: the value of business acumen in nursing, the gaining of business acumen in healthcare as a nursing leader, and the utilising business acumen as a nurse leader in the healthcare industry. CONCLUSION While nursing leadership and management were well researched, limited studies covered the specific focus of business acumen in healthcare for nurses or broader clinicians. IMPLICATIONS FOR NURSING MANAGEMENT While evidence points towards business acumen being important for healthcare leaders in balancing care and cost, inadequate research limits the recognition of these professional capabilities of nurse leaders. Further understanding could inform future policy and curriculum, as well as empower our next generation of clinicians.
BACKGROUND For over two decades, nurse-led critical care outreach services have improved the reco... more BACKGROUND For over two decades, nurse-led critical care outreach services have improved the recognition, response, and management of deteriorating patients in general hospital wards, yet variation in terms, design, implementation, and evaluation of such services continue. For those establishing a critical care outreach service, these factors make the literature difficult to interpret and translate to the real-world setting. AIM The aim of this study was to provide a practical approach to establishing a critical care outreach service in the hospital setting. METHOD An international expert panel of clinicians, managers, and academics with experience in implementing, developing, operationalising, educating, and evaluating critical care outreach services collaborated to synthesise evidence, experience, and clinical judgment to develop a practical approach for those establishing a critical care outreach service. A rapid review of the literature identified publications relevant to the study. A modified Delphi technique was used to achieve expert panel consensus particularly in areas where insufficient published literature or ambiguities existed. FINDINGS There were 502 publications sourced from the rapid review, of which 104 were relevant and reviewed. Using the modified Delphi technique, the expert panel identified five key components needed to establish a critical care outreach service: (i) approaches to service delivery, (ii) education and training, (iii) organisational engagement, (iv) clinical governance, and (v) monitoring and evaluation. CONCLUSION An expert panel research design successfully synthesised evidence, experience, and clinical judgement to provide a practical approach for those establishing a critical care outreach service. This method of research will likely be valuable in other areas of practice where terms are used interchangeably, and the literature is diverse and lacking a single approach to practice.
The large scale and rapid spread of the current COVID-19 pandemic has changed the way hospitals a... more The large scale and rapid spread of the current COVID-19 pandemic has changed the way hospitals and other health services operate. Opportunities for patient-centered decision-making at the end of life are being jeopardized by a scarcity of health system resources. In response, the traditional doctor-initiated advanced care planning (ACP) for critical illness may also need to be readjusted. We propose nurse-led and allied health-led ACP discussions to ensure patient and family inclusion and understanding of the disease prognosis, prevention of overtreatment, and potential outcomes in crisis times. We highlight known barriers and list enablers, long-term and short-term opportunities to assist in the culture change.
The centre of care: NP leadership in the provision of patient-centred, collaborative health care ... more The centre of care: NP leadership in the provision of patient-centred, collaborative health care I t is an exciting time for the nursing profession in Australia, as national health reform and the Healthier Medicare Review are creating the potential for new opportunities to lead the way in primary health care and chronic disease management. Nurse practitioner (NP) roles supporting chronic disease management are in place across Australia in a range of settings. In primary health care NPs are providing clinics and home based services that are demanded by the community, but more could be achieved through regulatory changes and appropriate funding models. Health system leadership is critical for shaping the future of health care in Australia and around the world. The Australian Government report from the Primary Health Care Advisory Group, recognised nurse practitioners as preferred clinicians, with the clinical expertise and accountability to lead the ongoing care of the patient, oversee the delivery of continuous and comprehensive care and to provide the link between the patient, their family and carers and the health system more broadly. This is important recognition and establishes the need to lead further discussions about new models of care.
AIM To explore the current evidence on business acumen of nurse leaders. BACKGROUND Health system... more AIM To explore the current evidence on business acumen of nurse leaders. BACKGROUND Health systems across the world are under immense pressure to stay solvent, maintaining services within a defined budget as we recover from the COVID-19 pandemic. Effective nurse leaders not only need to have strong leadership and management skills, but also strong business acumen to navigate the complexity of the system. EVALUATION A scoping review of research was undertaken, using PRISMA scoping extension checklist, with 571 studies found across multiple databases, 17 meeting final review eligibility. KEY ISSUES Findings were noted surrounding three themes: the value of business acumen in nursing, the gaining of business acumen in healthcare as a nursing leader, and the utilising business acumen as a nurse leader in the healthcare industry. CONCLUSION While nursing leadership and management were well researched, limited studies covered the specific focus of business acumen in healthcare for nurses or broader clinicians. IMPLICATIONS FOR NURSING MANAGEMENT While evidence points towards business acumen being important for healthcare leaders in balancing care and cost, inadequate research limits the recognition of these professional capabilities of nurse leaders. Further understanding could inform future policy and curriculum, as well as empower our next generation of clinicians.
BACKGROUND For over two decades, nurse-led critical care outreach services have improved the reco... more BACKGROUND For over two decades, nurse-led critical care outreach services have improved the recognition, response, and management of deteriorating patients in general hospital wards, yet variation in terms, design, implementation, and evaluation of such services continue. For those establishing a critical care outreach service, these factors make the literature difficult to interpret and translate to the real-world setting. AIM The aim of this study was to provide a practical approach to establishing a critical care outreach service in the hospital setting. METHOD An international expert panel of clinicians, managers, and academics with experience in implementing, developing, operationalising, educating, and evaluating critical care outreach services collaborated to synthesise evidence, experience, and clinical judgment to develop a practical approach for those establishing a critical care outreach service. A rapid review of the literature identified publications relevant to the study. A modified Delphi technique was used to achieve expert panel consensus particularly in areas where insufficient published literature or ambiguities existed. FINDINGS There were 502 publications sourced from the rapid review, of which 104 were relevant and reviewed. Using the modified Delphi technique, the expert panel identified five key components needed to establish a critical care outreach service: (i) approaches to service delivery, (ii) education and training, (iii) organisational engagement, (iv) clinical governance, and (v) monitoring and evaluation. CONCLUSION An expert panel research design successfully synthesised evidence, experience, and clinical judgement to provide a practical approach for those establishing a critical care outreach service. This method of research will likely be valuable in other areas of practice where terms are used interchangeably, and the literature is diverse and lacking a single approach to practice.
The large scale and rapid spread of the current COVID-19 pandemic has changed the way hospitals a... more The large scale and rapid spread of the current COVID-19 pandemic has changed the way hospitals and other health services operate. Opportunities for patient-centered decision-making at the end of life are being jeopardized by a scarcity of health system resources. In response, the traditional doctor-initiated advanced care planning (ACP) for critical illness may also need to be readjusted. We propose nurse-led and allied health-led ACP discussions to ensure patient and family inclusion and understanding of the disease prognosis, prevention of overtreatment, and potential outcomes in crisis times. We highlight known barriers and list enablers, long-term and short-term opportunities to assist in the culture change.
The centre of care: NP leadership in the provision of patient-centred, collaborative health care ... more The centre of care: NP leadership in the provision of patient-centred, collaborative health care I t is an exciting time for the nursing profession in Australia, as national health reform and the Healthier Medicare Review are creating the potential for new opportunities to lead the way in primary health care and chronic disease management. Nurse practitioner (NP) roles supporting chronic disease management are in place across Australia in a range of settings. In primary health care NPs are providing clinics and home based services that are demanded by the community, but more could be achieved through regulatory changes and appropriate funding models. Health system leadership is critical for shaping the future of health care in Australia and around the world. The Australian Government report from the Primary Health Care Advisory Group, recognised nurse practitioners as preferred clinicians, with the clinical expertise and accountability to lead the ongoing care of the patient, oversee the delivery of continuous and comprehensive care and to provide the link between the patient, their family and carers and the health system more broadly. This is important recognition and establishes the need to lead further discussions about new models of care.
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Papers by Chris Raftery