title: The chief nurse executive role in large healthcare systems.
abstract: Community hospitals are most frequently led by nonclinicians. Although some may have employed physician leaders, most often clinical leadership is provided by a chief nurse executive (CNE) or chief nursing officer. Clinical leadership of community hospital and health systems may similarly be provided by a system-level nursing executive or, often, by a council of facility CNEs. The increasingly competitive healthcare environment in which value-based purchasing of healthcare and pay-for-performance programs demand improved clinical performance for financial success has led to reconsideration of whether a council model can provide either the leadership or adequate attention to clinical (and operational) improvement. In turn, community hospitals and health systems look to CNE or chief nursing officer roles at the highest level of the organization as resources that are able to segue between the clinical and operational domains, translating clinical performance demands into operating strategies and tactics. This article explores CNE characteristics required for success in these increasingly responsible and visible roles.
authors.affiliation: Clinical Services Group, HCA, Inc, 1 Park Plaza, Nashville, TN 37203, USA. Jane.englebright@hcahealthcare.com
authors.forename: Jane
authors.initials: J
authors.lastname: Englebright
authors.forename: Jonathan
authors.initials: J
authors.lastname: Perlin
mesh_terms: D016542:Chief Executive Officers, Hospital / Q000458:organization & administration*; D002983:Clinical Competence; D003695:Delivery of Health Care / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006764:Hospitals, Community / Q000458:organization & administration; D006801:Humans; D007857:Leadership; D016347:Medical Records Systems, Computerized / Q000458:organization & administration; D016294:Models, Nursing; D017146:Models, Organizational; D009096:Multi-Institutional Systems / Q000458:organization & administration; D009718:Nurse Administrators / Q000458:organization & administration*; D024802:Nurse's Role; D010043:Outcome and Process Assessment, Health Care; D011367:Professional Staff Committees / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000458:organization & administration; D012052:Reimbursement, Incentive / Q000458:organization & administration; D017749:Total Quality Management / Q000458:organization & administration*; D014481:United States