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Development needs of advance practice nurses in a managed care environment
P R Ponte1, J M Higgins, J R James
1Brigham and Women's Hospital, Boston, MA.
The Journal of Nursing Administration
|November 1, 1993
Summary
A cost containment initiative in a teaching hospital led to significant changes in the clinical nurse specialist role. Development priorities were redefined to align with the redesigned responsibilities.
Area of Science:
- Healthcare Management
- Nursing Administration
- Organizational Change
Background:
- Teaching hospitals face increasing pressure for cost containment.
- Organizational restructuring is often necessary to address financial challenges.
- The role of clinical nurse specialists (CNS) can be impacted by such changes.
Purpose of the Study:
- To describe an organizational change process driven by cost containment.
- To analyze the resulting shift in the clinical nurse specialist role.
- To outline the evolution of CNS development priorities.
Main Methods:
- Case study of an organizational change in a US teaching hospital.
- Analysis of the cost containment drivers.
- Description of the redesign of the clinical nurse specialist role.
- Comparison of CNS development priorities pre- and post-change.
Main Results:
- A critical cost containment effort precipitated significant organizational change.
- The role of the clinical nurse specialist underwent a major transformation.
- Development priorities for CNSs were substantially altered following the role redesign.
Conclusions:
- Organizational change initiatives, particularly those focused on cost containment, can profoundly reshape specialized nursing roles.
- Adapting CNS development priorities is crucial for aligning with evolving healthcare demands and organizational structures.
- Effective management of role transitions is key to successful healthcare reform.