title: Clinical leadership in contemporary clinical practice: implications for nursing in Australia.
abstract: BACKGROUND
  Leadership in the clinical practice environment is important to ensure both optimal patient outcomes and successive generations of motivated and enthusiastic clinicians.
  
  
  OBJECTIVE
  The present paper seeks to define and describe clinical leadership and identify the facilitators and barriers to clinical leadership. We also describe strategies to develop clinical leaders in Australia. Key drivers to the development of nursing leaders are strategies that recognize and value clinical expertise. These include models of care that highlight the importance of the nursing role; evidence-based practice and measurement of clinical outcomes; strategies to empower clinicians and mechanisms to ensure participation in clinical decision-making.
  
  
  RESULTS
  Significant barriers to clinical leadership are organizational structures that preclude nurses from clinical decision making; the national shortage of nurses; fiscal constraints; absence of well evaluated models of care and trends towards less skilled clinicians.
  
  
  CONCLUSIONS
  Systematic, strategic initiatives are required to nurture and develop clinical leaders. These strategies need to be collegial collaborations between the academic and health care sectors in order to provide a united voice for advancing the nursing profession.
authors.affiliation: School of Nursing, Family and Community Health, University of Western Sydney and Sydney West Area Health Service, Sydney. patricia_davidson@wsahs.nsw.gov.au
authors.forename: P M
authors.initials: PM
authors.lastname: Davidson
authors.forename: D
authors.initials: D
authors.lastname: Elliott
authors.forename: J
authors.initials: J
authors.lastname: Daly
mesh_terms: D001315:Australia; D002322:Career Mobility; D002983:Clinical Competence; D003299:Cooperative Behavior; D003659:Decision Making, Organizational; D004509:Education, Nursing, Continuing / Q000458:organization & administration; D019317:Evidence-Based Medicine; D006291:Health Policy; D006301:Health Services Needs and Demand; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D016294:Models, Nursing; D009042:Motivation; D009313:National Health Programs / Q000458:organization & administration; D009718:Nurse Administrators / Q000193:education / Q000458:organization & administration* / Q000523:psychology; D009722:Nurse Practitioners / Q000193:education / Q000458:organization & administration; D024802:Nurse's Role; D009745:Nursing, Supervisory / Q000458:organization & administration*; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care; D010348:Patient Care Team / Q000458:organization & administration; D017009:Professional Autonomy; D013192:Staff Development / Q000458:organization & administration