Wilhelmina Manzano, MA, RN, a speaker at the marcus evans National Healthcare CNO Summit Spring 2010, shares her thoughts on the critical issues facing Chief Nursing Officers in North America.
Interview with: Wilhelmina Manzano, MA, RN, Senior Vice President & Chief Nursing Officer, NewYork-Presbyterian Hospital and Health Care System
Nursing is the backbone of a healthcare organization and central to patient care. Nurses are at the frontlines 24 X 7 and have a huge influence on patient care, patient outcomes and the overall experience of the patients. The majority of nurses’ time, however, is spent on non-clinical tasks, jeopardizing the “patient first” objective of many hospitals. Thus Chief Nursing Officers (CNOs) need to ensure they are up-to-date with advances in all areas of their industry to be able to implement changes that bring the focus back to the patient. Doctors come and go, but the nurse stays with the patient, says Wilhelmina Manzano, MA, RN, Senior Vice President and Chief Nursing Officer at NewYork-Presbyterian Hospital and Health Care System. A speaker at the marcus evans National Healthcare CNO Summit Spring 2010, taking place in Florida, April 25-27, 2010, Manzano discusses the strategies that have been successful at NewYork-Presbyterian, named one of America’s top ten best hospitals.
What are the most prominent issues challenging CNOs at the moment?
Wilhelmina Manzano: The key priorities that I focus on as CNO are: maintaining a healthy, competent, robust nursing workforce, aligning Nursing’s goals with the hospital’s so I can better support the organizational initiatives, improving the work environment of the nursing staff, leadership development, the role of technology in healthcare communications, efficiency and patient safety and of course how the healthcare reform will impact healthcare organizations and hospitals, including Nursing.
Preparing future nurses, preparing good leaders and making sure that they have the right skills are very important as we get ready for the changes ahead.
What strategies have you implemented to overcome some of these issues?
Wilhelmina Manzano: We stay focused and disciplined around the hospital’s and Nursing’s strategic initiatives and goals. Central to this is “putting patients first”, caring for them with compassion, effectively, efficiently, the right way, the right time, all the time.
We have developed a multi-year Nursing Strategic plan. Central to the plan is how we transform nursing practice and care at the bedside. Many of the key initiatives support those of the hospital’s: professional development and education, quality and patient safety, technology, financial and operational efficiencies, partnerships, and serving the community.
Even though there continues to be a nursing shortage, our reputation and the growth opportunities we offer in our five campuses means that people see our organization as a good place to work and advance. We also ensure that we have competitive compensation packages and a comprehensive orientation program for new graduate nurses. We have a nurse residency program for new graduates and a critical care internship program for those lacking in intensive care experience. When people see a supportive leadership and work environment, they tend to be happier and satisfied, and they stay. This also translates into a better patient experience and satisfaction.
Health information technology is clearly showing incredible promise in helping us improve the quality and safety of the care we provide our patients every day. Health care professionals are eager to have real-time data, better tools to manage clinical data, advanced tools to communicate with each other, and make real-time decisions about patient care. The interface between quality, information technology and Nursing is helping us ensure better quality of care
We try to help reduce expenses across the institution by working very closely with our procurement and supply sourcing department, looking at the products nurses use at the bedside and evaluating whether another product could do the same job at a lower cost, without sacrificing on quality. We focus on many initiatives to improve throughput and efficiency in the EDs and efforts to reduce inpatient length of stay.
We have implemented a nursing electronic documentation system and piloted a bar coding medication administration technology which helps nurses save time, but more importantly, ensures the right medication is administered to the right patient.
What long-term strategies would you recommend to CNOs?
Wilhelmina Manzano: The environment is changing so quickly, expectations and priorities are now different and are continuing to evolve. It is critical for a CNO to continue to grow and learn as a person, as a professional, and as a leader. It is very important to form and nurture effective collaborative relationships, not just vertical relationships but also horizontally. Nursing is not an individual sport – we are part of a big team that touches patients’ lives and impacts their families. And so the team relationships and dynamics are important and will be even more critical going forward.
We need to educate the nurses of the future, make sure they have the right competencies to take care of complex, multi-symptom, multi-disease patients. We need to develop and mentor future nurse leaders. Nursing executives need to align Nursing with the rest of the hospital and communicate the goals and mission to all levels of clinical and non-clinical staff. That is the only way we can be successful, and it is easier for us to align everyone around a central theme: it is about taking care of patients. That is what we do.
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