Transformational leadership
Transformational Leadership positions our nursing team to help achieve organizational goals. Leaders inspire nurses to put their knowledge and expertise to work, advocate for resources, and communicate processes that will improve care and the nurse practice environment.
In 2024, our nurses demonstrated Transformational Leadership by impacting the organization through efforts that include:
- A study focused on nurse leaders’ well-being
- A nursing leadership conference designed to provide growth opportunities for current and aspiring leaders
- Implementing acuity-based staffing to improve nurses’ workload and improve patient outcomes
Nurses work to fill a gap with research on leaders' well-being
Despite the wealth of studies focused on clinical nurses’ well-being, coping and resilience, there is a lack of information on these attributes for nurse leaders (defined as nurses with at least one direct report). To bridge this gap, a group of nurse scientists and nursing leaders at Children’s Health launched a mixed-methods study – both quantitative and qualitative – to investigate the unique characteristics of this population.
The Mayo Wellbeing Index was the quantitative instrument. For the qualitative portion, the research team conducted confidential interviews with nurse leaders and coded the interviews.
Quantitative results showed an opportunity to reduce nurse leaders’ stress and improve their well-being. Nurse leaders had a 13% higher level of stress than the national average for clinical nurses.
Qualitative results showed nurse leader fulfillment is related to well-being. Nurse leader well-being involves a complex interaction of individual resilience factors, leader competencies and system factors.
Researchers identified areas where enhancement can improve nurse leaders’ well-being:
- Mindset reframing using self-compassion and self-awareness
- Nurse leader mentor program
- Self-care behaviors during workday
- Nurse leader operational orientation, including business skills
- Support for nursing professional governance
- Development of shared values and behaviors within team cultures
The study was presented at the Association for Leadership Science in Nursing International Conference in Dallas in September 2024.
Nurse leaders host conference to drive collaboration and growth
In September, nurse leaders from Children’s Health hosted the Nursing Leadership Conference to help aspiring and current nurse leaders from Children’s Health and three additional organizations across the region address key challenges. With more than 100 nurses in attendance, the annual event resumed for the first time since the COVID-19 pandemic. Presentations were themed “Deep in the Heart of Texas:”
- “Hold Your Horses” on staff resiliency by Jean Storey, MSN, RN, NEA-BC, SRVP
- “Wild Wild West” on moral distress and ethical dilemmas in nursing leadership by Caitlin Reaves, BSN, RN, CPN, and Stephen Couch, M.A., ACC, HEC-C
- “These Boots are Made for Walking” on stepping into your potential by Jill Shepherd, BSN, RN, CPEN
- “Don’t Mess with Texas” on workplace violence by Benjamin Norris, M.S., WPVP, CIT
- “Texas State of Mind” on emotional intelligence by Denise Boensch, M.S.
- “The Lone Star State” on emergency management and Texas regulations by Megan Street, M.D., Emergency Medicine Physician and Professor of Pediatrics, UT Southwestern Medical Center
- “This Ain’t My First Rodeo” on multigenerational workforce by Daphney Fenelon Ford, MBA, and Michelle Prudhomme-Coleman, MBA, M.A.
Children's Health launches acuity-based staffing to enhance quality care and patient safety
In 2024, nurse leaders at Children’s Medical Center Dallas leveraged an electronic acuity-based staffing tool on select inpatient units, marking a significant milestone for our organization. The initiative follows more than a decade of research into workload acuity in a pediatric setting, in partnership with the health system’s electronic health record (EHR) vendor.
Acuity-based staffing leverages the EHR’s workload acuity tool to assess nurses’ workload per patient, factoring in orders, labs, medications, treatments and documentation. The system calculates minutes of care required per shift, enabling leaders to more effectively assign nurses based on patient needs.
The primary goal of acuity-based staffing is to enhance quality care and patient safety, while a secondary objective is to improve nurses’ work experience. An earlier pilot showed promising results, including a reduction in hospital acquired conditions (HACs) and post-survey improvements in nurse-perceived ability to provide quality care. Based on this success, leaders began expanding the model across the Dallas campus in 2024.
Aligned to the organization’s goal, nurse leaders advocated for the expansion of acuity-based staffing, contributing to a 25% reduction in HACs from 2023 to 2024. Our organization had a mean of 4.19 out of 5 for the Magnet RN satisfaction category “adequacy of resources and staffing,” outperforming the national benchmark.