Nemours Children’s Hospital: Teaching Charge Nurses How To Understand And Communicate Financial Performance Indicators

nurse leaders and training staff

Nemours Children’s Hospital (NCH) in Orlando, FL opened its doors in 2012 and has quickly become one of the premier children’s hospitals in the country, providing a full spectrum of pediatric care to its young patients. Nursing Director of Professional Excellence, Toni Christopherson, described the nursing team as exceptional, passionate and always willing to go the extra mile for the children and families entrusted in their care.

When Nemours leaders decided to add charge nurses to every shift on every unit, they sought out a training program that would give their emerging leaders the development needed to effectively manage a nursing team. With that in mind, NCH chose Catalyst Learning’s NCharge® curriculum. NCharge offered new nurse leaders evidenced-based professional development, and CLC provided a means to measure the effectiveness of the training.

NCH tapped into an initial cohort of 30 nurses to take NCharge courses. These nurses had been providing stellar direct patient care, but had no formal healthcare leadership training. While they are still early in the process, Christopherson pointed out that the organization is already seeing benefits from the training. Nemours is on a Magnet journey, and strives for a cultural transformation in nursing.

In addition to learning basic leadership skills like conflict resolution and meaningful communication, the instruction covers the financial implications of hospital value-based purchasing, which builds a common understanding Charge Nurses wouldn’t otherwise have, according to Christopherson. “When a Charge Nurse understands the basic concepts of financial management, they can see how their role affects financial performance,” said Christopherson. “The Charge Nurse can also articulate financial issues to the nursing unit they are leading and have more informed conversations with Nurse Managers and other leaders.”

Christopherson believes NCharge courses also help a Charge Nurse speak the same language as senior leaders. The learning and class discussions build an appreciation for what goes into making good business decisions that contribute directly to business outcomes and ultimately patient care. The courses Charge Nurse Fundamentals and Supervisory Skills for Positive Outcomes especially helped Nemours’ core group of first-level nurse supervisors to develop an understanding of how their roles impact financial stewardship and performance.

“Even more importantly, our Charge Nurse development initiative is helping these vital supervisors to promote continuous quality improvement, develop clinical leadership, manage team performance and contribute to delivering the organization’s objectives,” said Christopherson.

In regards to ROI of leadership development, Christopherson added that CLC’s use of the Kirkpatrick Learning Evaluation Model allows Nemours to measure results and impact of the training. The model looks at satisfaction and participation; knowledge acquisition; behavioral application; measurable business improvement; and return on investment. Early in the process, both participants and managers who supervise them indicated increased knowledge.

NCH is now turning its attention to how well the new Charge Nurses apply the knowledge they gained, behavioral application. Charge Nurses meet monthly and discuss application of the learning such as the need for enhanced patient throughput structure and process to impact the safety and quality of care. The Charge Nurses decided to implement a night shift Charge Nurse huddle. “Charge Nurses meet at 2300 to conduct proactive staffing that has increased the visibility of the bed planning process and allowed for targeted staffing specific to patient needs,” said Sophy Rodriquez, Nemours Catalyst trainer. For example, they discuss pending surgical cases, anticipated time back from the OR, and then staff appropriately to meet the patient’s needs. Ultimately, NCH will evaluate how the training impacts turnover, retention, promotion and patient care, and calculate the cost savings and/or increased revenue that comes from these gains. Christopherson noted that this sort of evaluation helps leadership understand the value of professional development.

“We want the whole organization to understand the value of education and professional development because it does reduce costs and add up to better safety and care,” said Christopherson.

The NCharge training initiative is NCH’s first step in operationalizing its nursing succession plan. It wants to be proactive in identifying high potential nurses and needed role competencies, and formally develop the right future nurses to assume leadership roles. Developing nurse  leaders, building the leadership pipeline, and pursuing Magnet designation is Nemours’ focus in pursuing nursing excellence for the children it serves.