Executive Nursing Leadership: Change and Conflict related to the Triple Aim

Abstract

Executive nurses work at the top of organizations and face unique challenges in today’s healthcare system. This qualitative study investigated the lived experiences of executive nurses to better understand their leadership journey. This study explored the professional development of executive nurses navigating change and conflict. The study used phenomenological inquiry and gathered data through individual semi-structured interviews, workplace observations, and document reviews. Based on the collected data experiential themes were identified. The study focused on executive nursing and the Institute for Healthcare Improvement’s (IHI) “Triple Aim” of creating better patient experiences, reducing system cost, and improving population health. The study interpreted critical turning points in executive nurses’ careers and triangulated data to identify, then, analyze central themes. Through the analysis of themes, new insights were created which connected current executive nurse functioning and future healthcare design. As a result, this study informed future thinking. The semi-structured interviews uncovered points of major change and conflict; particularly, related to fundamental organizational transformation, strategic goals, and the “Triple Aim”. Six key themes affecting executive nurse leadership emerged. The six key themes included: Focusing on population health, relationships, knowledge of the healthcare environment, technical leadership and change management skills, defined professional competencies, and central business skills. To provoke innovation and thought leadership, the six themes were interpreted using Zweig’s (2012) Class Theory, Shiva’s (2005) Perceptions of Corporate Power, and Plato’s Allegory of the Cave (Duarte, 2012)

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