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Nurse Leaders in the Boardroom The skills you need to be successful on a board
Presented by  the Center to Champion Nursing in America, an initiative of the  Robert Wood Johnson Foundation, the AARP Foundation and AARP
Nursing Leadership in the Boardroom Why Now? Why Me? What do I need to be Board-Ready? How to Prepare Call to Action On the path to Board Leadership 3
Why Now? Health Care Reform Needs Nursing Leadership Passage of  federal health care reforms  Greater need for nursing leadership in a reformed health care system Realizing the vision will require a leadership transformation in nursing
Why Now? Opinion Leaders Want NursingLeadership Gallup poll: Nursing Leadership from  Bedside to Boardroom: Opinion Leaders’ Perceptions Nurses ranked lowest among professions and groups who will influence health care reform in next 5-10 years. Top barriers to nurses’ influence and leadership were  “not important decision makers” and physicians “are revenue generators.” Almost all say nurses should have more influence in planning, policy and management. Nurse Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions (January 2010) conducted by Gallup, funded by the Robert Wood Johnson Foundation.  5
Why Now? Opinion Leaders Want Nursing Leadership Assuming a Leadership Role What, if anything, do you think could be done to ensure that nurses take on more leadership in improving health status and delivering healthcare services in the United States today?  Nurse Leadership from Bedside to Boardroom: Opinion Leaders Perceptions (January 2010) conducted by Gallup, funded by the Robert Wood Johnson Foundation.  41 6 % % % % % % %
Why Now? Nurses Underrepresented on Boards Nurses account for only 6% of boards seats in hospitals nationwide. American Hospital Association. (2001) AHA Hospital Statistics. Chicago, IL 7
Why Now? IOM Future of Nursing Report Recommendations Prepare and enable nurses to lead change to advance health: Nurses should take responsibility for their personal and professional growth by continuing their education and seeking opportunities to develop and exercise their leadership skills. Nursing associations should provide leadership development, mentoring programs, and opportunities to lead for all their members. Nursing education programs should integrate leadership theory and business practices across their curricula, including clinical practice. Public, private, and governmental health care decision makers at every level should include representation from nursing on boards, on executive management teams, and in other key leadership positions. Committee on the Robert Wood Johnson Foundation Initiative at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011.  8
9 Why Now?  Future of Nursing Report Nurses Underrepresented   Opinion Leaders Want Nurse Leadership Health Care  Reform NURSE LEADERSHIP IN BOARDROOMS
Why Me? Nurses Role in the Future of Health Care Nurse Leadership — Missing in the Boardroom Picture Nurses can and do bring to a boardroom: ,[object Object]
 Connections
 Keen assessment skills10
Why Me? Unique Patient Care Perspective ,[object Object]
Expert knowledge of quality care and patient safety
Fraud fighters, innovators and problem solvers
Understand interprofessional collaboration among all health care professionals11
Why Me? Nurses Benefit from Board Service ,[object Object]
Gain new knowledge
Get to know your own worth
Impact health care delivery
Obtain new skills
Meet new people
Expand your networks
Be inspired12
On the path to board leadership Responsibilities and Roles of a Board Member What do I need to know to become “Board-Ready”? 13
Stewardship 14
STEWARDSHIP The key quality of a steward is the belief in something greater than yourself. Taking a multidimensional position—means placing the best interest of the organization above career advancement, special interest groups, personal agendas.  15
STEWARDSHIP Steward of the organization’s values, beliefs, missions and visions. Responsibility to act in the best interest of the organization in exercising  its authority Accountable to the boards’ constituents and stakeholders for all decisions and actions To hold something in trust for others 16
STEWARDSHIP: Accountability 17 A Board ensures that the organization: ,[object Object]
Implements actions and policies that actively serve the organization’s mission.
Is accountable in their practices and policies.,[object Object]
Governance &  Board Responsibilities 19
GOVERNANCE Core Values are qualities, standards or principles  regarded as desirable, important and worthy of esteem. Vision defines the desired or intended future state of an organization. Mission is why the organization exists to serve and what it does for those it serves. 20
GOVERNANCE Principles of  Governance 21 Lead by example Contribute for the good of the organization Take collective action Uphold an organization’s mission and vision Do no harm to the organization
GOVERNANCE Public Image The board is the public face of the organization and is responsible for promoting the mission, vision and programs. Articulate the purpose, achievements and future plans of the organization and how it will positively impact the community. 22
GOVERNANCE  The process of governance is making and implementing decisions   Operational Performance Governance Functions of Board of Directors Strategic Planning & Direction Policymaking Advocacy Stakeholder Relationships Fiduciary Oversight Fund Development Leadership Development 23
RESPONSIBILITIES Evaluate how effective the organization’s management is in meeting goals. Operational Performance 24 Establish Transparency Maintain Confidentiality Continuous Improvement
RESPONSIBILITIES Plan an organization’s direction for success and the strategy or course of action necessary to move in that direction.  Strategic Planning & Direction 25
RESPONSIBILITIES Express the board and organization’s view, commitment and values on an issue – as the basis for action.   Policymaking 26
RESPONSIBILITIES Advocate on behalf of the communities served by the organization ensuring quality, safety and customer satisfaction. Advocacy 27
RESPONSIBILITIES Identify, prioritize and understand (people, groups, organizations and systems) stakeholders that affect or can be affected by the board’s actions. Stakeholder Relationships 28

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Nurse Leaders in the Boardroom

  • 1. Nurse Leaders in the Boardroom The skills you need to be successful on a board
  • 2. Presented by the Center to Champion Nursing in America, an initiative of the Robert Wood Johnson Foundation, the AARP Foundation and AARP
  • 3. Nursing Leadership in the Boardroom Why Now? Why Me? What do I need to be Board-Ready? How to Prepare Call to Action On the path to Board Leadership 3
  • 4. Why Now? Health Care Reform Needs Nursing Leadership Passage of federal health care reforms Greater need for nursing leadership in a reformed health care system Realizing the vision will require a leadership transformation in nursing
  • 5. Why Now? Opinion Leaders Want NursingLeadership Gallup poll: Nursing Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions Nurses ranked lowest among professions and groups who will influence health care reform in next 5-10 years. Top barriers to nurses’ influence and leadership were “not important decision makers” and physicians “are revenue generators.” Almost all say nurses should have more influence in planning, policy and management. Nurse Leadership from Bedside to Boardroom: Opinion Leaders’ Perceptions (January 2010) conducted by Gallup, funded by the Robert Wood Johnson Foundation. 5
  • 6. Why Now? Opinion Leaders Want Nursing Leadership Assuming a Leadership Role What, if anything, do you think could be done to ensure that nurses take on more leadership in improving health status and delivering healthcare services in the United States today? Nurse Leadership from Bedside to Boardroom: Opinion Leaders Perceptions (January 2010) conducted by Gallup, funded by the Robert Wood Johnson Foundation. 41 6 % % % % % % %
  • 7. Why Now? Nurses Underrepresented on Boards Nurses account for only 6% of boards seats in hospitals nationwide. American Hospital Association. (2001) AHA Hospital Statistics. Chicago, IL 7
  • 8. Why Now? IOM Future of Nursing Report Recommendations Prepare and enable nurses to lead change to advance health: Nurses should take responsibility for their personal and professional growth by continuing their education and seeking opportunities to develop and exercise their leadership skills. Nursing associations should provide leadership development, mentoring programs, and opportunities to lead for all their members. Nursing education programs should integrate leadership theory and business practices across their curricula, including clinical practice. Public, private, and governmental health care decision makers at every level should include representation from nursing on boards, on executive management teams, and in other key leadership positions. Committee on the Robert Wood Johnson Foundation Initiative at the Institute of Medicine. The Future of Nursing: Leading Change, Advancing Health. Washington, DC: The National Academies Press; 2011. 8
  • 9. 9 Why Now? Future of Nursing Report Nurses Underrepresented Opinion Leaders Want Nurse Leadership Health Care Reform NURSE LEADERSHIP IN BOARDROOMS
  • 10.
  • 12. Keen assessment skills10
  • 13.
  • 14. Expert knowledge of quality care and patient safety
  • 15. Fraud fighters, innovators and problem solvers
  • 16. Understand interprofessional collaboration among all health care professionals11
  • 17.
  • 19. Get to know your own worth
  • 25. On the path to board leadership Responsibilities and Roles of a Board Member What do I need to know to become “Board-Ready”? 13
  • 27. STEWARDSHIP The key quality of a steward is the belief in something greater than yourself. Taking a multidimensional position—means placing the best interest of the organization above career advancement, special interest groups, personal agendas. 15
  • 28. STEWARDSHIP Steward of the organization’s values, beliefs, missions and visions. Responsibility to act in the best interest of the organization in exercising its authority Accountable to the boards’ constituents and stakeholders for all decisions and actions To hold something in trust for others 16
  • 29.
  • 30. Implements actions and policies that actively serve the organization’s mission.
  • 31.
  • 32. Governance & Board Responsibilities 19
  • 33. GOVERNANCE Core Values are qualities, standards or principles regarded as desirable, important and worthy of esteem. Vision defines the desired or intended future state of an organization. Mission is why the organization exists to serve and what it does for those it serves. 20
  • 34. GOVERNANCE Principles of Governance 21 Lead by example Contribute for the good of the organization Take collective action Uphold an organization’s mission and vision Do no harm to the organization
  • 35. GOVERNANCE Public Image The board is the public face of the organization and is responsible for promoting the mission, vision and programs. Articulate the purpose, achievements and future plans of the organization and how it will positively impact the community. 22
  • 36. GOVERNANCE The process of governance is making and implementing decisions Operational Performance Governance Functions of Board of Directors Strategic Planning & Direction Policymaking Advocacy Stakeholder Relationships Fiduciary Oversight Fund Development Leadership Development 23
  • 37. RESPONSIBILITIES Evaluate how effective the organization’s management is in meeting goals. Operational Performance 24 Establish Transparency Maintain Confidentiality Continuous Improvement
  • 38. RESPONSIBILITIES Plan an organization’s direction for success and the strategy or course of action necessary to move in that direction. Strategic Planning & Direction 25
  • 39. RESPONSIBILITIES Express the board and organization’s view, commitment and values on an issue – as the basis for action.   Policymaking 26
  • 40. RESPONSIBILITIES Advocate on behalf of the communities served by the organization ensuring quality, safety and customer satisfaction. Advocacy 27
  • 41. RESPONSIBILITIES Identify, prioritize and understand (people, groups, organizations and systems) stakeholders that affect or can be affected by the board’s actions. Stakeholder Relationships 28
  • 42. RESPONSIBILITIES Monitor the financial health of the organization and ensure that appropriate financial controls are in place. Fiduciary Oversight 29
  • 43. RESPONSIBILITIES Lead in building philanthropic support to ensure the organization’s financial security. Fund Development 30
  • 44. RESPONSIBILITIES Address the development of future leaders to keep the organization moving forward, particularly in times of change or need. Leadership Development 31 Evaluate Mentor Orient Train
  • 45. 32 Completing the Board Leadership Puzzle
  • 46. How to Prepare Planning & preparing to succeed on a board 33
  • 47. Be Passionate How to Prepare Find a board that has a mission, values and/or vision you feel passionately about. Have the energy, commitment and enthusiasm to be a board leader by utilizing your personal and professional skills and interests. 34
  • 48. How to Prepare Identify the board you want to serve on and how to get there. Create a Personal Strategic Plan Plan Before you begin…do your homework! 35
  • 49.
  • 50. Serve on a committee at work.
  • 51. Engage in local policy-making, for example, on a community board or committee.Start Locally 36
  • 52. How to Prepare Nurses interested in leadership positions should seek the advice of other leaders. - Find a mentor Build Connections - Volunteer - Network 37
  • 53.
  • 55. Programs at graduate business schools
  • 57. Best on Board
  • 58. Center for Creative Leadership
  • 60. Governance for Health Care Providers
  • 61. The Growth and Development of Nurse Leaders
  • 64. Center for Health Care Governance
  • 68. Call to Action Now is the time to take your leadership to the next step! 39
  • 69. Acknowledgement This is a program of the Center to Champion Nursing in America an initiative of the Robert Wood Johnson Foundation, the AARP Foundation and AARP Content Acknowledgements: Sigma Theta Tau’s Non-Profit Board Governance for Health Care Leaders Online Education Program Presentation Moderator: TBD Video Contributors: Michael Bleich, Ph.D., R.N., F.A.A.N. Catherine Dodd, Ph.D., R.N. Catherine “Alicia” Georges, Ed.D., R.N., F.A.A.N. Donna Policastro, R.N.P. Antonia Villarruel, Ph.D., R.N., F.A.A.N. Presented by the Center to Champion Nursing in America, an initiative of the Robert Wood Johnson Foundation, the AARP Foundation and AARP
  • 70.
  • 71. BoardSource Governance Series Kit [www.boardsoure.org]
  • 73.
  • 75. Best on Board [www.bestonboard.org]
  • 76.
  • 79. Governance for Health Care Providers by David B. Nash, William J. Oetgen, Valerie P. Pracillo
  • 80. The Heart of Leadership by Barbara Balik and Jack A. Gilbert
  • 81. Ethical Governance in Health Care: A Board Leadership Guide for Building an Ethical Culture by Joel D. Ohlsen, Thomas P. Holland, Roger A. Ritvo
  • 82.
  • 83. Sigma Theta Tau [www.nursingsociety.org]
  • 85. Center to Champion Nursing in America [www.championnursing.org]
  • 86. Initiative on the Future of Nursing [www.thefutureofnursing.org]
  • 87. Robert Wood Johnson Foundation [www.rwjf.org]
  • 88.
  • 89. Board Leadership Magazine [www.onlinelibrary.wiley.com]
  • 90. Self Assessment Exams [e.g. www.bocatc.org]

Hinweis der Redaktion

  1. Introduction:Nursing leadership is essential for our nation’s health care system to achieve its promise and potential – for patient-centered, high quality, cost-effective health care that is accessible for all. There are many ways for nurses to be leaders – in their jobs, in the community and in government. Today we are going to focus on one important, distinct leadership role, that of boardroom leadership.The purpose of the presentation today is to begin to help you get “board ready” – with a combination of preparation and inspiration.
  2. This presentation was developed under the guidance of the Center to Champion Nursing in America – a joint program of AARP, the AARP Foundation, and the Robert Wood Johnson Foundation. These organizations are strongly committed to increasing the leadership role of nurses in health and healthcare, and we thank them for their contributions to our profession.
  3. Introduction:During this presentation we’ll focus on five points: Why now is a critical time to serve on a board Why nurses can be an asset to a board What is expected during board service Ways you can start preparing for your board leadership and, finally, a resource guide to help you put a plan into action To help make this information come alive, you’ll also see videotaped interviews from five other nurse leaders who have served on boards, who will give you a firsthand perspective of the skills you need and good ways to acquire and hone those skills. The information will provide a broad understanding of board service, not only for hospital or health systems, but for non-profit, educational and government councils and boards. Our goal is to hope motivate and prepare you to get on the path to board leadership! [CLICK – arrow will display the text on the path to board leadership]
  4. There are a number of reasons why the timing is particularly opportune for nurses to play a greater role on boards. [CLICK—Text will appear: Passage of the Patient Protection and Affordable Care Act]The first is the historical passage of the Patient Protection and Affordable Care Act. It’s hard to overestimate the impact this legislation will have, perhaps most widely in expanding coverage to 32 million currently uninsured Americans.But the goals of healthcare reform are to go beyond increasing coverage and access to improving health and healthcare, while bending the cost curve. And for that to happen, [CLICK]— Text will appear: Greater need for nursing leadership in a reformed health care system] nurses – with their unique perspective on patient care, must be at the table helping shape changes. Being at the table will require a transformation in nursing as well. [CLICK— Text will appear: Realizing the vision will require a leadership transformation in nursing]Nurses need to hone and develop their leadership skills to fulfill this new role.
  5. The fact is that nurses are not now perceived as being influential leaders in health care. The Robert Wood Johnson Foundation commissioned a Gallup study to examine the perception of nurses’ leadership role in healthcare reform, policy and management.Gallup surveyed more than 1,500 thought leaders from insurance, corporate, health services, government, industry and higher education. We all know other Gallup survey data that ranks nurses first among professions in trustworthiness. But, among these opinion leaders, the perception is that they will not be influential in health care reform. When asked what the barriers were to nurses achieving this influence, respondents said that nurses weren’t important decision-makers and physicians generate the income.But there was some very good news in this survey too. Almost everyone said that nurses should have more influence in every facet of health care, including planning, policy and management.(It’s important to note that they were commenting on current revenue generation model which may change based on the future including impact of ACA)
  6. SusanReinhardIt’s probably no surprise to you, but nurses are also chronically under-represented on hospital and health system boards. A 2010 survey of over 1,000 hospitals by the American Hospital Association found that nurses made up only 6 percent of board members, compared to 20 percent of board seats held by physicians. In another survey, researcher Dr. Larry Prybil and his team at the University of Iowa interviewed the board leadership at a number of hospital and health systems. He theorized that outdated perceptions of nurses as lacking leadership skills, gender bias and a lack of understanding of nurses’ roles in determining care quality could be preventing decision-makers from considering nurses as board members. Again, we find a gap between the value and leadership we know nurses can provide, and the perceptions of other health care decisions makers. It’s time to close that gap.
  7.  The status quo clearly is no longer acceptable.  That is one reason that the Robert Wood Johnson Foundation worked with the Institute of Medicine to release a landmark report in October of last year called The Future of Nursing: Leading Change, Advancing Health. It offers an action-oriented blueprint including changes in public and institutional policies and the importance of interprofessional collaboration. The report explores how nurses' roles, responsibilities, and education should change to meet future demands for care, framed within the context of the health care team.And many of those recommendations have to do with preparing and enabling nurses to lead change.  They include: [CLICK and READ TEXT—first box will appear][CLICK and READ TEXT—second box will appear][CLICK and READ TEXT—third box will appear][CLICK and READ TEXT—fourth box will appear]Now we will hear what Dr. Michael Bleich [pronounced BL-LYE], a nurse leader and one of the IOM committee members had to say about the recommendations. [CLICK— image to play video]
  8. So why is now the right time for nurses to participate in board leadership?Realizing the promise of health reform requires our skills and perspectivesNurses are underrepresented on boardsHealth care opinion leaders agree that nurses should play a greater leadership roleAnd the IOM report calls for nurses to play a greater role in leadership at all levels
  9. Now let’s discuss whynurses need to consider serving on a board. [CLICK— image to play video]As you just heard, nurses bring a unique perspective to the boardroom. Nurses are involved with almost every aspect of patient care delivery. They provide an essential point of view on a number of critical issues currently facing our health care system.[CLICK— Text will appear at the bottom of the slide]In addition to having patient-focus, nurses also can bring connectionsbetween organizations setting policy for quality and safety and the patients they treat. Nurses have enormous credibility with patients and their families, but also with policymakers, employers and health plans. And they enjoy high public trust, as the top-ranked profession for the last eight years in a Gallup poll of honesty and ethics.
  10. [CLICK— image to play video]As these nurses just said, “we already have many of the qualities needed to serve on a board,” such as: [CLICK—first text will appear] Nurses have firsthand insight into the views and concerns of patients and families. [CLICK—second text will appear]Nurses have expert knowledge of how best to achieve high quality care and increase patient safety. [CLICK—third text will appear]Nurses help solve long-standing problems, including combatting fraud, and creating innovative solutions to improve patient care. [CLICK—fourth text will appear]Nurses also understand the need for interprofessional collaboration among all health care professionals —including nurses, physicians, pharmacists, therapists and frontline workers – both in hospital and community settings.
  11. It’s not all about nurses giving to others – board service can also be personally and professionally rewarding as well. [CLICK— image to play video][CLICK—text will appear]Board service is not only an exercise in exercising leadership, it expands those skills, and advances your capabilities and knowledge. It provides you with the opportunity to meet people and expand your networks beyond those in your current job. It can feel empowering, and inspirational too!
  12. So we’ve spent some time talking about Why, now let’s discuss How and What - the responsibilities of serving on a board, and the skills you’ll need. [CLICK—text will appear saying What do I need to know to become “Board-Ready”?]
  13. First up is Stewardship.
  14. [CLICK—text will appear at bottom of screen about taking a multidimensional position]Stewardship is placing the interests of the organization above yourself or the advancement of any special interest group or personal agenda. It’s about taking a multidimensional position – understanding the big picture and broad perspective.Being a good steward begins with reacquainting one’s self with these values as a critical component of leading.[CLICK— image to play video]In other words, [CLICK—text will appear in center of slide about key quality]It’s about a belief in, and allegiance to, something greater than yourself.
  15. When stewardship is practiced by a board, it acts in accordance with:[CLICK—first text box will appear]An organization’s values, beliefs, mission and vision.[CLICK—second text box will appear]A deep understanding of how to best exercise authority having the best interest of the organization in mind.[CLICK—third text box will appear]Knowledge that you are accountable for its work to its constituents and stakeholders.[CLICK—fourth text box will appear]It is the responsibility of a board member to take care of what belongs to the organization, for the present and the future.[CLICK— image to play video]
  16. Part of being a steward involves--accountability. A board member has the responsibility and authority to act in the best interest of the organization. [CLICK—The title of the blue box will slide in from the left and the three points in the box will appear]Being accountable also means it is a board’s responsibility to ensure they: Adhere to the law and to ethical standards.Accept responsibility for their actions, and the outcomes of those actions.Put into place both policies and actions that serve the organization’s mission.An accountable board is one that is open to its constituents about their decision making, policies and processes. [CLICK— image to play video]The board as a whole, and its individual members, are answerable for all that the organization does, and how it does it. The board is called to account for the organization.
  17. Another important part of stewardship is responsibility. The board has a responsibility for managing and making decisions at a level that will guide and direct the organization as it carries out its mission.  The primary legal duties of serving with responsibility includes:1.)CARE[CLICK—first text will appear with definition of care]By exercising care, a board member is both informed about the organization and active in its decisions. Her or she is familiar with the services provided by the organization, including how these services are funded, and the costs incurred in delivering these services.2.) LOYALTY[CLICK—second text will appear with definition of loyalty]Loyalty requires board members to act in the best interest of the organization and to avoid any transactions in which they may benefit personally.  3.) OBEDIENCE[CLICK—third text will appear with definition of obedience]Obedience requires adherence to the organization’s bylaws as well as government regulations, and to understand and advance the mission of the organization.[http://www.bonadio.com/care-loyalty-and-obedience-%E2%80%93-how-get-your-nfp-board-board]
  18. Now, I’ll talk about the role of governance, and specific responsibilities of serving on a board.Although stewardship and governance go hand and hand—because they both involve making informed, strategic choices for the good of the organization—stewardship focuses on the greater good, while governance is the process by which the greater good is served and realized.
  19. Governance is the process and structure of providing strategic leadership to an organization. It involves decision –making in key areas , as well as the process by which decisions are implemented.Effective governance is critical to the success of any organization and is critical responsibility of board members. [CLICK— image to play video]As you just heard, there are underlying standards of governance which include:1.) VALUES[CLICK—first text will appear with definition of values]Core values are the qualities, standards or principles that are important to the organization. These values are the foundation which an organization exists.2.)VISION[CLICK—second text will appear with definition of vision]Vision is what is wanted for the organization, what it will look like, be experienced as, and be like in the future. 3.) MISSION[CLICK—third text will appear with definition of mission]Mission is why the organization exists, whom it exists to serve and what it does for those it serves. It is the justification for the organization's existence and is explicit about the human or societal need it fills.
  20. Also critical to understand are the basic principles of governance.[CLICK— image to play video]Some other key principles of governance include:[CLICK—first text will appear with do no harm to the organization]Effective governance means boards access, evaluate and judge how well or how poorly the organization is doing. Boards determine if the organization is meeting its constituents’ needs and if these actions are consistent with the organization’s values and beliefs.[CLICK—second text will appear with contribute for the good of the organization]Boards must make decisions for the betterment of the organization, grounded in the belief that they will bring about the desired result. [CLICK—third text will appear with lead by example]A board and its members lead and encourage others to act in the best interest of the organization. [CLICK—second text will appear with take collective action]Boards are a community of individuals which bring different perspective, talents and expertise. The diversity mandates that boards operate in an environment of free dialogue that is dependent on each person’s participation and individual contribution. Decisions are board actions not individual actions.[CLICK—third text will appear with uphold an organization’s mission and vision]Boards are the keepers of the organization’s mission.
  21. The board is the public face of an organization as well as the link between staff, volunteers and constituents. It becomes a board member’s responsibility to promote the mission, vision and programs of the organization as well as to positively represent it.[CLICK— image to play video][CLICK—text will appear in blue box with The key of public image is to articulate the purpose,achievements, purpose and future plans of the organization and how it will positively impact the community]The public persona that the board assumes for the organization can take many forms from public speaking to fundraising, to testifying before legislatures and annual written reports.
  22. Now let’s dig a little deeper into the specific functions that make up the process of board governance [CLICK- arrow will appear with text]These include:[CLICK—first text box will appear Operational Performance][CLICK—second text box will appear Strategic Planning and Direction][CLICK—third text box will appear Policymaking][CLICK—fourth text box will appear Advocacy][CLICK—fifth text box will appear Stakeholder Relationships][CLICK—sixth text box will appear Fiduciary Oversight][CLICK—seventh text box will appear Fund Development][CLICK—eighth text box will appear Leadership Development]We will go over each of these responsibilities in greater depth to provide you with a thorough understanding.
  23. First, Operational Performance[CLICK- definition will appear as will text in the rotating image]Effective boards examine how successfully they are operating as well as how effective management is meeting the goals of the organization. Boards monitor management through establishing outcome goals and metrics.  In exercising this function, (Note: text below aligns with text portrayed in image)Establish mechanisms of transparency so others can see the integrity of their decisions and actions. Boards also look for continuous improvement in organizational performanceMaintain the confidentiality of their deliberations[CLICK— image to play video]
  24. Strategic planning and direction is different from operational planning. [CLICK— image to play video][CLICK- definition will appear as will text in the image]Boards implement strategic planning by determining:What the environment is in which the organization must succeed; What they want to achieve; How they will measure success; What few things they must do outstandingly well during their tenure to be successful; And how they will structure and inspire others to succeed at the highest level.Boards must discuss each one of these questions, informed by information and expertise; then, make decisions to guide the organization’s direction for success and the strategy or course of action necessary to move in that direction.
  25. Before I talk about policy making, listen to what some of the nurse leaders had to say.[CLICK— image to play video][CLICK- definition will appear as will text in the image]Policy is defined as a statement in which an organizational value or belief is expressed as the basis for action.Board policies express the board and the organization's view, commitment and values on an issue. The board has the authority to develop policies on whatever it wishes as long as that policy supports the organization’s values. Boards define the principle or concept and delegate it for implementation.
  26. [CLICK- text will appear with definition of advocacy]Advocacy is defined as "the act or process of ... supporting a cause or proposal.“ Board members are advocates for the communities and constituencies that their organizations serves. This is not a new role for nurses, who have long been advocates their patients and for high-quality care, accessible to all.Effective advocacy for nurse leaders in the boardrooms of hospitals and other healthcare organizations includes:Demonstrating the perspective that patient care is important within the organization’s work. Assuring that the clinical perspective is included in the organizational decisions, when appropriate.Ensuring that nurses are actively involved in decisions that affect practice and the health care system as a whole. That said, it is very important to emphasize that a nurse must never go onto a board with the expectation of advocating solely for other nurses. You are not the “nurse representative” on a board – your role is to advocate on behalf of those the organization serves. [CLICK— image to play video][AORN Journal Article http://findarticles.com/p/articles/mi_m0FSL/is_5_81/ai_n13793213/pg_2/?tag=content;col1]
  27. [CLICK- text will appear with the definition]Boards implement responsibilities related to Stakeholder Relationships by identifying, prioritizing and understanding people, groups, organizations and systems (stakeholders) who affect or can be affected by their actions. In identifying stakeholders, a board must ask: Who will be affected by our decisions? Who has influence over their decisions? Who has a vested interest in the success or failure of their action. These people or groups become their key stakeholders.When prioritizing stakeholders, boards place at the top those who have the power to advance their decisions – and those with the power to block those decisions. Boards must keep these stakeholders fully informed and engaged. To do this, boards must seek out the thoughts and feelings of these stakeholders on issues, and find ways to address their concerns. [CLICK— image to play video]
  28. Fiduciary responsibility can sound more complex and intimidating than it needs to be. First, let’s hear from our nurse leaders . [CLICK— image to play video][CLICK- text will appear with definition]In exercising fiduciary oversight, boards approve financial plans and policy . It’s not just about financial oversight, it’s also about the policies that shape finances. Boards monitor the financial health of the organization and ensure that appropriate financial controls are in place. This includes assessing resources and putting in place procedures that ensure the sustainability and stability of the organization. Financial responsibilities of the board include planning, budgeting, monitoring and managing risk.Boards also have the responsibility to ensure that all legal requirements are met and that independent audits are regularly conducted and reviewed.  
  29. Perhaps one of the most daunting things to nurses considering board leadership is fund development – a fancy way of saying fund raising; which is, of course, closely tied to fiduciary responsibility. [CLICK- text will appear with definition]Boards become the primary fundraisers for the organization. They are not necessarily the largest donors themselves, but they must take the lead in attracting funding sources to the organization to ensure its financial viability.To do this, they help develop the rationale or the “case” for supporting the organization and effectively communicate this to prospective donors.  Boards act as stewards for the fundraising plan, monitoring and evaluating its outcomes. Most importantly, board members contribute individually and work to identify others who contribute. [CLICK— image to play video]
  30. [CLICK- text will appear with definition]Board members aren’t only leaders in their own right, they also address the leadership development of future leaders, themselves and the chief staff officer. Boards create systems and processes for building the leader bench strength of the organization. The goal of leadership development from the board’s perspective is to keep the organization moving forward, particularly in times of change or need. They understand the organization’s need for a pool of knowledgeable, qualified leaders. [CLICK— image to play video]Boards create systems for developing talent and for eventual succession, which include these elements:[CLICK- yellow arrow will appear] [CLICK- first word will appear] TRAIN– identifying and preparing individuals for leadership positions as well as attending to the board’s own leadership development needs.[CLICK- second word will appear] ORIENT— providing the needed information about the organizational purpose, goals, programs and services to enable a new member to contribute in a meaningful way.[CLICK- third word will appear] MENTOR— sharing, teaching and learning from the knowledge and skills of other board leaders.[CLICK- last word will appear] EVALUATE— assessing how well the board is meeting its responsibilitiesin leadership development.
  31. [NO CLICK NEEDED--Title of slide will appear automatically saying completing the board leadership puzzle]Now that you’ve been given an overview of the responsibilities of boards, you may be wondering how to acquire the skills you need to serve, and how to be considered for board service. So let’s discuss how to complete that piece of the board leadership puzzle.
  32. We’ve gathered insights for you from nurse leaders who have served on boards. Their advice includes:Be passionate. Create a Personal Strategic Plan. Start Locally. Build Connections. And Seek Ongoing Education. We’ll go through each of these recommendations on steps to plan and prepare for board service in greater detail, so in addition to serving on a board…. [CLICK- Text will appear in the middle of the recommendations saying planning and preparing to succeed on a board]…you can succeed on a board.
  33. [CLICK- Text will appear and definition will automatically follow] Think about the issues about which you are most passionate— perhaps children, elderly care, gender inequalities — and on which you have some knowledge or skill.[CLICK— image to play video]Find an organization – perhaps first a local organization - that has a mission, value and/or vision that feel passionately about.[CLICK- image of other recommendations will appear]Dedication to a cause. For example, Catherine Dodd sits on the Breast Cancer Fund board because she cares deeply about the issue.Willingness to commit.Before you join, make sure you understand the time and commitment it takes to serve on a board. Board service isn’t just about showing up to meetings, it’s about actively participating - by being prepared and providing solid input to the discussion.Goal for the overall good of an organization.Choose a board that has an overall mission that you can support.Demonstrate Expertise.Passion must be accompanied by expertise - board members must bring something to the table, whether industry expertise or financial or legal expertise, or understanding of key stakeholders.
  34. [CLICK- Text will appear and definition will automatically follow as will text in blue box] The next step is creating your own personal strategic plan for achieving your goal of board participation. A personal strategic plan has several elements. You need to spell out your objectives – or what you want to achieve. Then, you need to come up with specific tactics or action steps. What are the specific things you need to do? What do you need to learn? How are you going to learn them? Whom do you need to talk to? What is your time line for each step along the way?The act of creating your own strategic plan will give you direction, will make it obvious what you know and what you need to learn – and should include milestones and markers to let you know if you’re on the right path.[CLICK— image to play video]
  35. [CLICK- Text will appear and definition will automatically follow as will text in box] Leadership and board skills don’t develop overnight – they take time to grow. And the best way to do this is to start in your community and look for opportunities for service. Think first about local non-profit or community organization – join and volunteer to serve on a committee or project. You can also volunteer to serve on committees at work, in state and national nursing organizations, or in local government. Committee work is the first rung in the leadership ladder. Assume responsibility within these organizations and do a good job.Become familiar with how an organization implements meetings, learn how to facilitate a meeting and to present your ideas persuasively both verbally and in writing. All of this can help you become known as a leader in the organization, so that you’re considered for a board position. Here are some thoughts about how starting local can be beneficial from our nurse leaders…[CLICK— image to play video]
  36. [CLICK- Text will appear and definition will automatically follow as will text in box] Nurses must begin to build connections only in our own profession, but within our communities and more widely as well. Take visible leadership roles in areas of substance and impact. Advocate for action at the local, state and/or federal level. Get out there and develop the connections you need to make your name known.[CLICK— image to play video]Other important ways to build connections include:[CLICK- first box will enter from the bottom] Find a Mentor– Find a leader who has already achieve some of the goals you aspire to. Maybe another nurse, but also consider other professions – someone who is willing to advise you, give concrete advice, who can enhance your professional development and will encourage you to reach your end goal.[CLICK- second box will enter from the bottom] Volunteer-- Individuals who truly embrace an issue or an organization—and are willing to invest sweat in helping that issue or organization—will volunteer to get a firsthand perspective of the people, the language and the values needed to support the cause.[CLICK- last box will enter from the bottom] Network-- Develop a networkof allies - both male and female– who serve as executives or board members of companies and organizations, especially ones outsidenursing and health care.
  37. [CLICK- Text will appear and text in both blue boxes will automatically appear]If you are serious about joining a board, take the time to invest in yourself through continuing education on leadership and board skills.These are a few suggestions – we’ll give you a detailed handout of resources at the end of this presentation. Sigma Theta Tau offers an excellent on-line education program that serves as an introduction to board service, and we relied on much of its content to shape this presentation. Graduate business schools offer board training programs, as well as organizations such as the Center for Creative Leadership that offer training and certification.There is a lot of reading material out there – books on governance, Trustee Magazine for hospital board members, and a number of websites with excellent information. As we’ve touched on today, serving on a board requires specific expertise in board governance as well as general leadership skills – and these resources are a good way to acquire greater board knowledge.
  38. Now more than ever nurse leadership is needed in the boardroom. With health care in a period of reform and transformation, our skills and insight are needed at the decision-making table – in hospitals, at non-profits, in business and in government.I hope after this presentation you understand the need for undertaking this next, new step in leadership. I hope that you feel newly inspired and informed to take the steps necessary to meet this critical challenge. [CLICK— image to play video][CLICK- the text in yellow box will be underlined, “Now is the time to take your leadership to the next step”]
  39. Thank you.
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