Over a year ago, Cincinnati-based UC Health adopted a site leadership model where each of its two acute-care hospitals is led by a registered nurse. This shift, according to Rob Wiehe, the former chief administrative officer of University of Cincinnati Medical Center and current systemwide COO of UC Health's hospital division, has proven advantageous and is a strategy he intends to maintain.
"It's really important to have, if possible, that nurse leadership at the top," Mr. Wiehe told Becker's. "I definitely think the integration, within our end, has been a plus, and it's a model I'd like to continue to keep, although healthcare changes, and we'll adapt as needed."
As part of the leadership model, UC Health combined the chief administrative officer and CNO positions at both hospitals.
Jennifer Jackson, DNP, RN, rejoined UC Health as its vice president of operations, West Chester (Ohio) Hospital site leader and chief nursing officer, effective Sept. 11, 2023. Dr. Jackson replaced Tom Daskalakis, who was appointed permanent chief administrative officer and vice president at West Chester Hospital in 2017.
Additionally, Teri Grau, RN, whose previous title was vice president and CNO of University of Cincinnati Medical Center, is now the site leader for the hospital.
In discussing the approach, Mr. Wiehe noted the value nurses bring to administration, including an essential frontline perspective.
"Their integration into these executive roles really just strengthens patient-centered decision-making," he said.
He also said the shift to the model was "a deliberate step toward creating that more integrated and collaborative leadership structure with nurses at the center of operational and clinical decision-making combined. It's allowed us to streamline leadership. It brings that clinical expertise again directly into our operational strategies, and it has fostered that alignment between care delivery and administrative functions."
UC Health does not yet have specific data related to the leadership model and potential effects on patient experience, patient outcomes, or recruitment and intention. However, Mr. Wiehe did point to other effects.
He said the approach has helped foster a culture of shared governance and professional growth.
"When you have a nurse leader as your site leader, it takes on a little bit of a different personality," said Mr. Wiehe.
For example, amid UC Health's financial transformation, the health system used its shared-governance teams and models to identify supply chain improvement opportunities within inpatient units. This ultimately resulted in switching usage around some of the standardized, widely available supplies and products.
"It helped us really drive adoption of new and different supplies that we're confident are still focused around safety and quality, and we're not giving any of that up," he said. "But we had our nurse colleagues sitting at the table and really examining and had a very strong, if not the strongest, voice in that decision, and they helped us reach good [financial] outcomes."
Mr. Wiehe said the health system's shared-governance teams have also focused on helping nurses when they have challenging days.
"When they've had challenging families or challenging patients, they've had a voice. They've created safe spaces within the hospital where they could go and just relax and kind of recover from whatever they were dealing with while their teammates covered for them on the front line," he said.
He recommended that other systems contemplating a similar approach consider the importance of having the right person in leadership roles.
"If you had a leader who was only nursing centric and not able to work in a highly matrix environment, which academic medicine is, that it could be kind of insular," said Mr. Wiehe. "The caution is you need a leader who, yes, is an RN. Yes, in our instance, understands that front line and what's happening, the care pathways and can effectively work with their physician partners and with their ancillary services or even finance and other support services.
"They can't be so heavily nursing-focused, but having that nursing background, it really, if they have everything else, is such a big benefit."
Moving forward, UC Health is working with the University of Cincinnati College of Medicine to pair the health system's site leaders with the medical school's executive leaders.
"We're going to make even better decisions when we have a dyad that's departmental leaders from the college with my site leaders who have both administrative and technical RN experience," Mr. Wiehe said.
"And we think that dyad is our next evolution of a decision-making structure, getting committees together, and making sure that you've got all the right people, physicians, administration and nursing at the table. We believe that that's going to result in us optimizing and moving faster and being more nimble."