Younger Samuel J
Department of Cardiac Surgery, Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee.
Nurs Adm Q. 2020 Apr/Jun;44(2):127-135. doi: 10.1097/NAQ.0000000000000408.
The US health care system has seen unprecedented growth in health care cost with only a mediocre return on investment. Achieving sustained quality improvement will require innovation that is effectively integrated into complex systems of care. Complexity leadership has the ability to place value on traditional quality improvement processes, with less focus on rigid structure and more attention on the potential for flexibility and creativity at the point of care. Clinical team leaders, such as nurse practitioners, must nurture adaptability to the constantly changing clinical environment while balancing structured thinking of team members. Nurse practitioners operating in interdisciplinary teams are well positioned to foster adaptive change through rapid cycle improvements at the point of care. As a learning approach to quality improvement, the PDSA (plan-do-study-act) method should be seen as a useful tool for organizations to create an emergent quality improvement process. This article discusses the significance of nurse practitioner leadership using the PDSA method informed by complexity leadership theory and the impact for clinical practice.
美国医疗保健系统在医疗保健成本方面经历了前所未有的增长，而投资回报率却仅处于中等水平。要实现持续的质量改进，需要将创新有效地融入复杂的护理系统中。复杂性领导力有能力重视传统的质量改进流程，减少对僵化结构的关注，更多地关注护理点的灵活性和创造力潜力。临床团队领导者，如执业护士，必须培养对不断变化的临床环境的适应能力，同时平衡团队成员的结构化思维。在跨学科团队中工作的执业护士处于有利地位，可通过护理点的快速循环改进来促进适应性变革。作为一种质量改进的学习方法，PDSA（计划-执行-研究-行动）方法应被视为组织创建新兴质量改进过程的有用工具。本文讨论了运用复杂性领导理论指导下的PDSA方法的执业护士领导力的重要性及其对临床实践的影响。
