Why Teach Charge Nurses About Financial Success Indicators?

Charge Nurse and VBP

Nursing executives generally agree that financial indicators of hospital success and reimbursement are often not understood by bedside nurses. That’s understandable, given that nurses join the profession because they care about people, not about finances. But not providing this knowledge keeps nursing staff from understanding the bigger picture and seeing the critical role they play in the connection between organization financial health and patient care quality.

Here are several reasons to teach your nurses, especially Charge RNs, about financial issues impacting the daily operations they impact:

Teaching nurses about financial indicators and VBP language will prepare them for future leadership roles
How can nurses prepare for future leadership roles if they don’t understand the language spoken by senior leaders? Nurses pursue the profession because they want to help patients, not think about cost containment, so ease them in slowly. Try forming a team, or cohort under a mentor nurse leader where they can collaborate around ways to improve financial performance. Shared governance is a way in which to promote leadership and accountability within the nurse population. Allowing nurses to find ways to improve, and methods by which to document accountability will help to promote buy-in and an ownership mentality. High-performing clinical nurses who also evidence the most interest in financial topics and hospital performance may be earmarked for possible future leadership roles.

More informed conversations with Nurse Managers and other senior leaders
Teaching your Charge Nurse about financials can help from the bedside up, when discussions with Nurse Managers and other leaders take place. This is a lesson from Nemours Children’s Hospital.

Nemours Children’s Hospital, Orlando FL

Toni Christopherson, Director of Nursing Professional Excellence at Nemours Children’s Hospital in Orlando said, “when a Charge Nurse understands the basic concepts of financial management, they can see how their role affects financial performance. 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. 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.” To read more about Nemours Children’s Hospital and how they trained a full staff of Charge Nurses to understand financial management, Click Here.

Ownership stake – Nurses should see how their role impacts Value Based Purchasing (VBP)
VBP speaks to the heart of what’s changing in healthcare reimbursement—a shift to payment for outcomes and quality. At a high level it doesn’t ask ‘How much did you do?’ but instead asks, ‘How well did you do?’ and, more importantly, ‘How well did the patient do?’ Nurses who understand financial metrics and VBP at even a moderate level will better understand the linkage between the financial health of the organization and its corresponding impact on providing the highest quality patient care. Encourage nurses to think of themselves as a vital player in maximizing VBP outcomes.

Improvement of nurse communication
Understanding of financial indicators contributes to improved communication in the hospital unit. Optimizing nurse communication has a direct and positive impact on HCAHPS domains as well as key clinical outcomes such as readmission rates and HACs. Communication has proven impact on VBP reimbursement levels.

Save money
Sound financial management is important in all healthcare environments, whether a system is for profit, not for profit, or publicly financed. To advocate successfully for the resources needed to staff and operate their units, nurses should have better understanding of hospital financial information and knowledge of healthcare costs. Decreasing non-reimbursable events (the “never” events like pressure ulcers, falls, hospital acquired infection) or reducing supply costs can affect the bottom-line for a unit. When nurses understand the nuts and bolts of budgets at the unit level, they are more motivated and involved in reducing costs. Charge Nurses in particular are the first-level supervisory nurse, and may see process improvement potential that more senior leaders don’t notice.

Prepare for a brighter future – for nurses, and for everyone
A shifting paradigm from “healthcare past” to “healthcare future” means new skills and vision are needed. The old healthcare paradigm was top-down hierarchical command and control with siloed care, with nurses not having the knowledge to lead. But for healthcare to move into the future, it will require a team-based, collaborative care approach. It is time for nursing to find their voice and take an active role in shaping the future of healthcare, and be recognized for their contributions in care coordination. Nurses in the transformed healthcare system will need to be able to gather data and track clinical and financial data over time and across settings. To lead, your nursing staff needs to know about financial sensitive indicators.


 Value-Based Purchasing: What’s the score? Raso, Rosanne MS, RN, NEA-BC, Nursing Management
Improving the Patient Experience Real-World Strategies for Engaging Nurses, Journal of Nursing Administration, Christina Dempsey, MSN, MBA, RN CNOR CENP Barbara Reilly, PhD Nell Buhlman, MBA
Healthcare Transformation and Changing Roles for Nursing” U.S. National Library of Medicine, February 2017, Susan Salmond and Mercedes Echevarria
“The business of caring: What every nurse should know about cutting costs,” American Nurse Today, Rose O. Sherman