Part 2: Inspiring Today's Nurse Leaders: A Conversation with Pamela Hunt, BSN, MSN, RN


Tue Mar 29 13:00:26 CDT 2016

Today’s nurse leaders play an important role in supporting the financial well being of their healthcare organizations. However, the demands of day-to-day clinical work don’t always afford them the opportunity to hone their financial skills.


As the chief nurse executive of the north region for the 14,000-employee Community Health Network in Indianapolis, Indiana, Pamela Hunt draws from her 17+ years’ experience as a nurse leader and administrator to enhance her peers’ financial management and operational planning prowess.


We recently spoke with Pam about the opportunities nurse leaders have to make a difference, both financially and operationally, within their organizations.


Part 2


Why should nurse leaders learn about financial management?


Our organizations have a responsibility to both the organization and to the patient. Nurses must learn financial management so that we can support the organization’s fiscal responsibility, which helps ensure quality for our patients.


If you’re a nurse leader and cannot describe what’s in the equation for staff productivity, or you don’t understand why flexing staff volume is so important, or you cannot improve productivity by matching hours required to the demand for nurses in the OR, or the patient’s bedside, then you’re not going to be successful, and your facility won’t be successful. And what may happen is your staff may be reduced because you’ve been inefficient.


As a nurse leader, the worst thing is to not be over or under budget.  The worst thing is to not be meeting budget and not know why. The nurse leader’s responsibility is to always question and understand why there’s a variance, which gives you the knowledge and power to do something about it. 


How do you see the role of nurse leaders evolving in their relationship with physicians to succeed in this era? What about suppliers? Patients?


Across our industry, we’re trying to get costs down to meet Medicare rates. To be successful healthcare organizations will need in embrace a variety of skill levels in the acute care setting. I think that the only way that we’ll be successful is having the right people in the right places, and that all nurses work at the top of their license. We’re going to see a wider range of people with different skills working in an acute care setting in order to get more hands at the bedside.


Advance practice nurses, or nurse practitioners (APRNs) must be able to work to the full extent of their skills, training and scope. We also need to look at roles and responsibilities for the RN, the licensed practical nurse (LPN), the nursing assistant and the certified medical technician (CMT) in acute care settings.


What can nurses do on the clinical side to have a positive effect on the financial side?


The nurse leader in the unit drives the clinical impact on financial outcomes by being open to suggestions and implementing the great ideas that staff brings to her or his attention. One of my sayings is that “Nobody knows better than the nurse at the bedside or in the OR what we’re opening and wasting, or what doesn’t work and is consuming our time and energy getting it to work.”


One of the suggestions I give nurse leaders in my seminar is to have all their team members complete an exercise with three questions. The first question speaks to productivity: “If I had an extra hour of work, I would do X.” The second question, which speaks to waste reduction, is, “We could save costs by doing Y.” The third question, which addresses patient, family and community sentiment and informs our marketing efforts, is: ”I would tell my family member to come into this hospital because of Z.”


By answering these questions, the nurse leader can harvest great ideas to improve productivity, reduce expenses and increase revenue by increasing volume


When staff have financial ‘skin in the game’, it’s always more meaningful to them.  So I think hospitals with gain sharing programs — that share financial rewards with employees when they reach margin, satisfaction and quality measures — are more successful than hospitals that don’t.


What are some key strategies to building collaborative teams?


Communicate to your team what you are looking for and why. Give them as much information as possible. Then ask them what ideas they have that you believe will solve the challenge.


Publicly reward employees for helping achieve cost savings or process changes. Over time you create a sense of culture that we’re here to do work efficiently and if we all do that well, we’ll all have jobs. And that’s important, because two of the four healthcare systems in our community had workforce reductions last year.


Cost, quality, outcomes and safety are all so critical to a hospital’s performance. How does a nurse leader strike a balance to focus on all?

You must constantly measure all of those things and understand you cannot have improvement in one area at the risk of failure in another. Financial health is connected to quality and to the patient’s perception of care.  Our region’s departmental monthly operating review scorecards includes measures such as retention rate, quality metrics, patient perception of care scores,  financial performance, and growth success. There is a cost to such quality events as:  a surgical site infection, an additional day of patient stay, and a medication error.


I tell my seminar participants about an inpatient unit where we decreased nursing hours per patient day. Six months later we revisited performance for that unit and discovered that its quality metrics were not being met. We went back and increased the nursing hours. It was costing us too much to be without that additional nursing support.


At a heart hospital I have responsibility for in the north region, the OR team demonstrated 14 months without a surgical site infection. Based on that standard of quality, we estimated  $200,000 cost savings compared to the heart hospital’s prior year performance.

Join the discussion!  Share your advice for tomorrow's nurse leaders in the comments section below.

Click here to read part one of this series.