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Background: In recent years, organizational leaders have faced growing pressure to respond to social and political issues. Although previous research has examined the experiences of corporate CEOs engaging in these issues, less is known about the perspectives of healthcare leaders., Objective: To explore the experiences of healthcare CEOs engaging in health-related social and political issues, with a specific focus on systemic racism and abortion policy., Design: Qualitative study using semi-structured interviews from February to July 2023., Participants: CEOs of US-based hospitals or health systems., Approach: One-on-one interviews which were audio recorded, professionally transcribed, and analyzed using thematic analysis., Key Results: This study included 25 CEOs of US-based hospitals or health systems. Almost half were between ages 60 and 69 (12 [48%]), 19 identified as male (76%), and 20 identified as White (80%). Approximately half self-identified as Democrats (13 [55%]). Most hospitals and health systems were private non-profits (15 [60%]). The interviews organized around four domains: (1) Perspectives on their Role, (2) Factors Impacting Engagement, (3) Improving Engagement, and (4) Experiences Responding to Recent Polarizing Events. Within these four domains, nine themes emerged. CEOs described increasing pressure to engage and had mixed feelings about their role. They identified personal, organizational, and political factors that affect their engagement. CEOs identified strategies to measure the success of their engagement and also reflected on their experiences speaking out about systemic racism and abortion legislation., Conclusions: In this qualitative study, healthcare CEOs described mixed perspectives on their role engaging in social and political issues and identified several factors impacting engagement. CEOs cited few strategies to measure the success of their engagement. Given that healthcare leaders are increasingly asked to address policy debates, more work is needed to examine the role and impact of healthcare CEOs engaging in health-related social and political issues., (© 2024. The Author(s), under exclusive licence to Society of General Internal Medicine.)

Loch Lomond Villa is one of the largest long-term care communities within the province of New Brunswick. Our organization supports caring living environments for over 450 clients and their family members along with 354 employees., (Copyright © 2021 Longwoods Publishing.)

In recent years, due to several health care system reforms in different countries, an increased involuntary turnover rate of Chief Nurse Executives has been reported around the World. However, no data on their perceived experience of their dismissal have been documented up to now in the European context. Describing the experience of involuntarily dismissed Chief Nurse Executives was the main aim of this interpretative phenomenological study. Data were collected through face-to-face audiotaped interviews performed by involving a purposeful sample of 13 Chief Nurse Executives; data analysis was performed by using the QSR NVIVO 11 software. The Chief Nurse Executives' experience of Being fired is characterized by three main themes: (1) "Health Care Institutions are places influenced by political turbulences"; (2) "My competence and presence in the arena is despised by a range of strategies"; and (3) "Transiting from darkness to light". According to their experience, the reason for dismissal was due to changes in the political climate and the introduction of a new chief executive officer; moreover, Being fired caused a deep pain similar to that experienced during bereavement. In some socio-political contexts, the political climate can influence the role of a Chief Nurse Executive: political membership, whether implicit or explicit, is considered of great value. In other contexts, the Chief Nurse Executives' value is based on professional competences and achieved outcomes. At times of changes in the political climate, the peculiarities of the specific socio-political context should be evaluated as to whether one should anticipate his/her resignation or not.

The traditional role of the chief nursing officer (CNO) is expanding to include new clinical areas and patient populations. Chief nursing officers find themselves challenged to balance both system and site priorities, compounded with the expectation to lead their organization during a merger, acquisition, or hospital closure and the changes in healthcare reimbursement. Chief nursing officers must anticipate emerging issues and be prepared to manage those issues. They are at high risk politically when a new chief executive officer is named and when hospitals are having financial concerns. How do we lead in times of turbulence? How can we ensure that high-potential candidates are prepared for the CNO role and what are the most critical competencies they will need? To address these concerns, we created a Chief Nursing Officer Academy (CNOA) that is designed for new and aspiring CNOs. This article provides an overview of the CNOA and a program evaluation of the outcomes for the participants.

A study was recently conducted to determine the perceptions of undergraduate health care management students regarding leadership characteristics that health care managers should possess to be successful. The results were then compared with a study that was conducted in 2012 of chief executive officers regarding their perceptions of the same leadership characteristics. The comparison of the studies was used to determine if the perceptions of the students and chief executive officers were similar or if the subjects considered different characteristics more important than others.

The chief executive role might be seen as the pinnacle of achievement for any executive working in a trust, but there is growing evidence that suggests many are reluctant to step up to the role.

This article examines the parameters and the dynamics of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) that create an ethical leadership dilemma to satisfy patients in the hospital setting while still ensuring appropriate care for quality clinical outcomes. Under the Affordable Care Act, hospitals and health care systems are in a high-stakes struggle of winners and losers based on HCAHPS scores. This high-stakes struggle creates unintended consequences of an ethical dilemma of doing what is right for the patient versus doing whatever it takes to please the patient in order to achieve high scores of satisfaction that are tied to better reimbursements. This article also reports the results of a national survey of 500 chief executive officers by the authors about the attitudes and frustrations of chief executive officers confronting the wild unrest caused by HCAHPS.

Brazil's economic and political crisis had never been deeper, hardening the way companies deal on the market. Only those that are able to deal with tougher market conditions remain in the game, while facing increasingly difficult situations. A continuous rise in competition has shrunk prices and compressed margins, imposing necessary improvements to the way companies work in order to remain sustainable. The healthcare market is no exception, and if leaders identify improvement opportunities for the way their companies deal with Revenue Cycle Management, they will easily be one step ahead of competition.

Traditional management skills are still crucial when it comes to keeping hospitals and health systems running smoothly, but as health care changes dramatically, boards also must consider "learning agility" and "emotional intelligence" when working with the C-suite.

Beginning in fiscal year 2013, scores based on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) constitute 30% of incentive-based payments from Medicare's Value-Based Purchasing (VBP) initiative. Yet there is little empirical work to understand hospital approaches to improving the patient experience. In this study, chief patient experience officers at 416 VHA hospitals were surveyed to assess the relationship between organizational characteristics and publicly reported HCAHPS scores. Of 416 institutions, 143 (34.4%) participated. Respondents reported that boards (68%) and chief executive officers (81%) viewed the patient experience as extremely important. In contrast, they reported that in only 15% and 34% of hospitals, respectively, physicians and nurses were supportive of efforts to improve the patient experience. Hospitals with collaborative cultures and higher physician engagement had higher VBP total HCAHPS scores (6.9 points and 8.2 points higher, respectively; both P < .05). These areas should be addressed to improve the patient experience in provider organizations., (© The Author(s) 2014.)

The purpose of this article is to discuss the role resilience plays for chief nursing officers who have experienced involuntary loss of their positions. Various definitions of resilience based on 3 stages of resilience inquiry that have evolved over time and the "Broaden-and-Build Theory" of positive emotions are presented. Based on this foundation, recommendations are presented to help these chief nursing officers develop or enhance their resilience to move forward to a successful future.

Ethical behavior is good for business in any organization. In healthcare, it results in better patient care, a more committed and satisfied staff, more efficient care delivery, and increased market share. But it requires leaders who have a broad view of the role that ethics programs--and an effective, sustained ethical culture--play. Ethical organizations have integrated and shared ethical values and practices, an effective ethics infrastructure, ongoing ethics education for staff at every level, ethical and morally courageous leaders, and a culture that is consistent with the organization's values. The mission, vision, and values statements of these organizations have been successfully translated into a set of shared values--a moral compass that guides behavior and decision making.

Based on a 2008 cross-sectional survey of 582 hospital CEOs in the United States, this study reports the findings of two logistic regression models designed to identify CEO and hospital characteristics associated with Member and Fellow status in the American College of Healthcare Executives (ACHE). The purpose of the study was to understand the personal and organizational characteristics of those CEOs who choose to be Members and Fellows of a professional association such as ACHE. The results showed that most (74 percent) of the respondents considered ACHE to be their primary professional association. The results also revealed that a master's degree in health administration [beta = .88, t(427) = 5.35, p < .0001], male gender [beta = .59, t(427) = 3.01, p = .002], and financial incentives provided by the parent hospital [beta = .25, t(427) = 2.73, p = .006] were statistically positively linked with Member status in ACHE. A master's degree in health administration [beta = .81, t(424) = 5.79, p < .0001], male gender [beta = .39, t(424) = 2.25, p = .02], and age [beta = .02, t(424) 2.32, p = .02] were also statistically positively associated with Fellow status in ACHE. Notably, organizational factors such as size, geographic location, for-profit status, and financial strength of the hospital do not seem to play an important role in the CEOs' decision to become a Member or Fellow of ACHE. The implication of these findings is that membership and fellowship at a professional association are influenced by characteristics of the individual, and incentives provided by employers can encourage employees to get involved with their professional associations.

Background: The resource-based view of the firm suggests that organizations must obtain valuable resources from external sources to obtain lasting benefits. Professional associations today exist in every industry and offer resources to assist their affiliates' organizations and individual members. Today, there are more than 23,000 national and 64,000 state, local, and regional professional associations that claim to significantly benefit their affiliates. The value of these benefits and what organizational and individual factors that may affect their value have not been explored., Purpose: This article explores the influence of organizational and individual factors on the value of resources offered by a prominent health care professional association., Methodology/approach: Data from a national survey of hospital CEOs were combined with American Hospital Association data for descriptive statistics and regression analyses to examine the organizational and individual characteristics influencing the value of professional association affiliation., Findings: Our research suggests that most hospital CEOs perceived value in the resources provided by their primary professional organization. In addition, both organizational and individual factors contributed to the perceived value of professional association affiliation. Significant organizational influences included hospital ownership and system membership, which were related to less importance and value from affiliation. Positive and significant individual characteristics included certification as an association fellow and CEOs who have a high value for coaching. Interestingly, men perceived less organizational value from affiliation and older CEOs saw less individual value., Practical Implications: Executives considering affiliating with a professional association can better understand how existing affiliates perceive and value the associations' benefits. In addition, executives and professional associations can be more informed how professional association affiliation is significantly influenced by organizational and individual characteristics. Individuals, organizations, and professional associations should be aware of the perceptions and differences among those who do and could avail themselves of professional association resources.

Introduction: A variety of studies have indicated that rural communities have fewer mental health services and professionals than their urban counterparts. This study will examine the shortages of mental health professionals in rural communities as well as the impact of inadequate mental health services access on rural hospitals., Methods: A sample frame of 1162 rural hospitals was compiled, and a two-page survey was mailed to each hospital Chief Executive Officer (CEO)., Results: Of the 1162 surveys mailed, 228 were returned. The majority of CEOs agreed that there was a shortage of mental health professionals, that referral centers were too distant, and that there were many barriers to care including infrastructure, poverty, and substance abuse. Solutions offered by CEOs included telemedicine and residency training programs., Conclusions: This study shows that many rural areas have great need for more mental health professional recruitment and retention.

The formal leadership of mental health care organizations commonly resides in an executive director, who may or may not have had clinical training. The medical director is a psychiatrist who reports to the executive director. For some, this arrangement suggests that the medical director lacks or has lost power in the organization. This paper examines more specifically the types of power available to the medical director using French & Raven (1959) and Raven (2008) bases of power framework. The executive director/medical director relationship can be thought of as a relationship between individuals holding formal and informal power, respectively. Although medical directors lack formal or positional power, they potentially have and can gain more informal power based on their recognized clinical/medical expertise, their personal presence and an assertive involvement and focus on the organizational mission.

Background: A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of race and ethnicity data in performance monitoring and quality improvement within hospitals., Methods: Thematic analysis of semi-structured interviews with executives from a representative sample of 28 Massachusetts hospitals in 2009., Results: The number of hospitals using race, ethnicity and language data internally beyond refining interpreter services increased substantially from 11 to 21 after the regulation. Thirteen of these hospitals were utilizing patient race and ethnicity data to identify disparities in quality performance measures for a variety of clinical processes and outcomes, while 16 had developed patient services and community outreach programs based on findings from these data. Commonly reported barriers to data utilization include small numbers within categories, insufficient resources, information system requirements, and lack of direction from the state., Conclusions: The responses of Massachusetts hospitals to this new state regulation indicate that requiring the collection of race, ethnicity and language data can be an effective method to promote performance monitoring and quality improvement, thereby setting the stage for federal standards and incentive programs to eliminate racial and ethnic disparities in the quality of health care.

Hospital chief executives are tapping physicians for upper management roles beyond the traditional chief medical officer and other primarily clinical positions. But often, these highly educated, entrepreneurial and strong-willed individuals need help acquiring the business and people skills to successfully make the transition.

Barrett's power theory provides a theoretical framework that can be applied to the practice of nursing administration. From this perspective, the role of the system chief nurse executive can be seen as an evolutionary emergent, that of chief vision officer. Various organizational initiatives relevant to this role are discussed as exemplars of practice informed by the Barrett's power theory.

This department, sponsored by the AONE, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. This article describes how 9 Magnet-hospital, chief nursing officers perceive their autonomy and its importance in accomplishing their work.

Objective: This American Organization of Nurse Executives study examined perceptions of staff nurses, nurse managers, and nurses in other organizational roles as part of an initiative examining CNO turnover. Here, we report findings that complete the 3-phased effort to better understand how nurse executive turnover affects the work environment and patient care., Background: The CNO plays a key role in promoting nurse satisfaction and improving quality, safety, and effectiveness in healthcare organizations. However, little is known about the impact of nurse executive turnover on staff, managers, or patient care delivery., Methods: An online survey was used to gather participants' views., Results: Approximately 1,277 nurses employed in hospitals across the United States responded to this survey. They reported that their CNO listened and responded to staff and backed up staff in decision making, even when doing so involved conflicts with physicians. However, they also perceived that the CNO was not always visible on units and accessible to staff and had less power and authority than other top-level hospital executives in the organization., Conclusion: Strategies are needed to address the concerns of staff nurses and managers who are left behind when CNO turnover occurs.