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FRONT-LINE COMPETENCIES > FOR NURSE AND MIDWIFE MANAGERS CONTENTS > 1 Planning and organisation 2 Building and leading a team 3 Leading on clinical practice and service quality
FRONT-LINE COMPETENCIES > FOR NURSE AND MIDWIFE MANAGERS
CONTENTS >
1 Planning and organisation2 Building and leading a team3 Leading on clinical practice and service quality
The work of front-line nurse managers has becomeincreasingly demanding and more complex as servicevolumes and patient expectations continue to grow.
Specifically in relation to front-line nursing and midwiferymanagement the Commission on Nursing recommendsthat front-line managers fulfil the following functions:
> professional/clinical leadership
> staffing and staff development
> resource management
> facilitating communication.
The Commission also recommends that clerical andinformation technology support should be made availableto nurse and midwife managers in order to support themin their managerial function.
The primary purpose of the role in front-line nursemanagement is to co-ordinate and lead theimplementation and delivery of nursing activities within acircumscribed unit of service. The unit of service may bea ward, a day treatment service, a geographicalcatchment area for public health, a communitypsychiatric nursing service, or a day or residential serviceunit for people with an intellectual disability.
Scope of the role
The role typically encompasses key result areasincluding
> planning of services in terms of need analysis,activities, targets and priorities
> deployment of resources, both human and physical,including budgeting, scheduling and task allocation
> the development of care and individual service plans
> providing leadership on standards and qualityassuring service delivery and evaluation
> acting as a professional role model, counselling,tutoring and mentoring less experienced staff
> acting as a focal service contact point and primaryliaison with other disciplines and servicecollaborators
> providing direction, support and supervision to front-line staff on the discharge of their roles
> providing a limited direct client service role, usually inareas of greater complexity or sensitivity.
Timeframe of impactShort-term impact of most decisions: from immediate toone month ahead.
Critical success factors in the role
> the effectiveness and quality of the service response
> the smooth co-ordination of resources and activities
> the efficiency of resource usage
> provision of leadership in crisis response
> setting a positive tone for the service delivery
> ongoing development of staff capability andperformance.
Evolving trends and role challenges
> greater input into resources planning andaccountability
> greater emphasis on tracking activity levels,processes and outcome against the resourcesdeployed
> trends towards more formalised and systematicapproaches to quality assurance and service audit.
> greater emphasis on multi-disciplinary models ofservice delivery
> challenge of keeping abreast with the latestdevelopments in service technology and of applyingresearch-led best practice in the practical servicedelivery context
> growing emphasis on consumer rights and the needto provide services that empower and positivelyeducate clients
> the emphasis on a continuity in service care acrossdelivery settings and programmes
> the research identifies three critical rolecompetencies as well as the full range of genericcompetencies that underpin management success atall levels.
Planning andorganisation
Building andleading a team
Leading onclinical practice
and service quality
Practioner competenceand professional
credibility
Promotion of evidence-based decision-making
Building and
maintaining
relationships
Communicationand influencing
skills
Service initiationand innovation
Resilienceand composure
Integrity andethical stance
Sustainedpersonal
commitment > >
>
FRONT-LINE COMPETENCY 1 > PLANNING AND ORGANISATION
Definition Plans and organises resources efficientlyand effectively within a specified timeframe. Co-ordinates and schedulesactivities. Manages unexpected scenarios.
AREAS OF APPLICATION
> Allocation and co-ordination of resources to achieve tasks, scheduling of rosters
> Procuring and evaluating material resources > Prioritisation and meeting demands under pressure or in emergencies> Record keeping and reports for operational activities> Planning of meetings, case conferences or other events
FRONT-LINE COMPETENCIES
>1 Planning and organisation
> Ensures maximum use of availableresources in annual, monthly and weeklyrostering
> Plans ahead to cover foreseeable demandsand eventualities
> Is proactive and flexible in problem solvingstaff shortages and demand fluctuations
> Plans and organises individual and groupprogrammes in a consultative way toachieve best possible outcomes
> Delegates well, giving clear taskaccountability and taking into account thestrengths, weaknesses and developmentneeds of staff
> Is proactive in evaluating client care andensures efficient planning liaison withinterdisciplinary colleagues
> Anticipates clinical problems or otherservice user issues and takes proactiveaction
> Responds in an organised and calm way tounexpected developments, quickly takingstock, and prioritises actions and resources
> Keeps open channels of communicationwith a range of relevant personnel acrossthe services (nurses, doctors, paramedical,technical, IT) etc
> Makes early contact with family and otherservice staff to plan and organise the nextsequence of care activities (i.e. transferacross programmes, community discharge)
> Rosters in a mechanical and routine waywithout thinking about demand patterns
> Does not anticipate scheduling problemsor leave issues etc
> Fails to anticipate staff shortages andmay respond in a blanket way that wastesresources
> Is more directive and less consultative inpatient allocation and does not linkactivities
> Is clinically competent but does notdelegate clearly and may lack knowledgeand insight of individual staff capabilities
> Is reactive in organising client care andlacks initiative in co-ordinatinginterdisciplinary activity
> Less adept at thinking ahead andanticipating client needs
> Concentrates too much on the presentdelivery of service (thinks today only)
> Responds in a disorganised manner tounexpected or crisis situations
> Works too much in a singular or singlediscipline manner and does not linkeffectively across services and staff
> Leaves continuity of care planning toolate and does not organise the nextsequence of service in a seamless way.
Indicators of MORE effective performance
Indicators of LESS effective performance
FRONT-LINE COMPETENCY 2 > BUILDING AND LEADING A TEAM
Definition Acts as a role model in terms ofcapability and professionalism. Leads ateam confidently, motivating, empoweringand communicating with staff to promoteprovision of a quality service. Blendsdiverse styles into a cohesive unit,coaches and encourages improvedperformance.
AREAS OF APPLICATION
> Promoting high standards in the daily running of the clinical services atunit level
> Leading and managing interdisciplinary care for service users> Empowering staff through team meetings, coaching, education and
promotion of staff initiatives
FRONT-LINE COMPETENCIES
>2 Building and leading a team
> Articulates a vision and sets clearobjectives for service delivery
> Provides a regular forum for staffcommunication, is receptive andrespectful of contributions from staff
> Leads and manages change. Makes apositive case for change
> Develops good team relations and dealspromptly with individual and teamdiscord, thus creating and maintainingfavourable working environment
> Understands the importance of cultureand good working relationships
> Deliberately monitors and works toimprove the team process, encouragesteam review and reflection
> Develops staff to their full potential bydevolving authority and responsibilitywithin professional limits
> Believes in and promotes the self-governance model
> Models excellent work practices and useshis/her skills to educate others throughcoaching, mentoring and thusdisseminates good practice
> Encourages initiative in staff and expectsindividual accountability, recognisespositive performance and interveneswhen standards fall
> Monitors workload pressures on staff andintervenes as appropriate
> Develops and maintains staff morale bydelegating appropriately, supporting,motivating and expecting individualaccountability
> Positively promotes change and leadsfrom the front in trying out new or betterways of delivering services.
Indicators of MORE effective performance
Indicators of MOREeffective performance
FRONT-LINE COMPETENCIES
>2 Building and leading a team
> Lacks enthusiasm and vision for theservice
> Lacks structure in eliciting contributionfrom staff and does not hold regularmeetings. May appear not to listen orvalue staff contribution
> Slow to develop the team. Requiresadvice and prompting to meet staff needs
> Fails to create an environment suitable forteam cohesion
> More comfortable following and avoidingteam conflict. Too concerned about whatothers may think or say
> Less concerned about workingatmosphere and does not appreciate itseffect. Does not see the importance ofshared success
> Uses an authoritarian or overly directiveapproach in work assignments
> Tells others what to do but does notdelegate stretching tasks or encourageautonomous practice
> Does not show confidence in the use ofthe self-governance model
> Knowledgeable and clinically competentbut does not participate in staffdevelopment and does not pass on skillsand knowledge to the team
> Relies heavily on the team to providenecessary care but does not liaise ormonitor demand levels on staff
> Slow to intervene when standards slip
> Ignorant of the type of pressures placedon staff and does not seek to alleviatestress
> Tends to follow rather then initiate change
> Takes few initiatives personally to improveservices and does not go out of way toencourage initiative.
Indicators of LESS effective performance
Indicators of LESS effective performance
FRONT-LINE COMPETENCY 3 > LEADING ON CLINICAL PRACTICE AND SERVICEQUALITY
Definition Sets and monitors standards and quality of service, leads on proactiveimprovement.
AREAS OF APPLICATION
> Ensuring that service users receive a good standard of clinical care andclient service
> Implementing and monitoring standards of clinical care for the service > Interdisciplinary networking to ensure high quality effective systems for
service delivery> Monitoring and evaluation of accommodation and catering services for
the service area
FRONT-LINE COMPETENCIES
>3 Leading on clinical practice and service quality
> Regularly reviews practice and clinicalstandards of care and measures them
> Judges clinical service provision based onclinical expertise
> Possesses sound knowledge ofprocedures and protocols in operationalmatters
> Develops new ideas in order to improvecare and optimise to full potential
> Identifies service problems – assesses,plans, and takes action
> Strives for leading edge in practice
> Stimulates and supports clinical andresearch initiatives to improve care
> Shows a strong knowledge of qualityassurance processes
> Identifies areas for quality improvementand works with interdisciplinary teammembers to improve particularprocesses/practices
> Regularly reviews the quality of hotel,catering and other support services. (e.g.CSSD). Convenes regular meetings forfeedback
> Encourages staff evaluation of suppliesand equipment (e.g. IV giving sets,syringe drivers and other pumps)
> Develops service user care plans, whichtranscend disciplines and programmes ofcare (e.g. hospital to community)
> Has an active involvement in contributingto policies, which are critical to patientcare
> Demonstrates high standards of practicein own work areas and acts as aprofessional role model for the staff
> Educates staff opportunistically on the job
> Monitors and scans the environment non-invasively, making sure everything runssmoothly
> Does a regular review of service userperspectives and complaints and ofincidents (e.g. falls) and seeks outmethods to achieve better outcomes.
Indicators of MORE effective performance
Indicators of MORE effective performance
FRONT-LINE COMPETENCIES
>3 Leading on clinical practice and service quality
> Lacks knowledge and expertise to judgeservice and clinical care provision by staff
> Ignores problems until they becomecritical and/or unmanageable
> Shows an inadequate knowledge ofprocedures and protocols
> Has no impetus to be a leader of clinicalpractice
> Would rather keep things the way theyare. Safer. Sees no need for change
> Is not comfortable with new initiatives andresearch. Sees these as barriers toproviding the service now
> Requires regular prompting frommanagers to review clinical standardsand avoids doing so
> Avoids involvement of staff in thedevelopment of quality initiatives forservice users
> Does not encourage staff to activelyparticipate in the review of ward/unitequipment. This results in dissatisfactionwith equipment/supplies
> Maintains barriers between inter-disciplinary teams, which results inconflicting plans and programmes of care
> Lacks understanding in theimplementation of quality policies. Takes a passive role in this area and does notkeep abreast of quality issues
> Works independently refining own skillsand knowledge but not sharing this withothers
> Maintains a closed mind and refuses toelicit or believe evidence. Does not wishto shape a service by what the ‘users’ say– there is only the professional way.
Indicators of LESS effective performance
Indicators of LESS effective performance
26 Harcourt StreetDublin 2tel 01 475 4044fax 01 475 4066email [email protected] www.officeforhealthmanagement.ie
