Advocate Health recently reimagined the role of nurse managers, said Jane Dus, DNP, RN, senior vice president and chief nursing officer of the system's Midwest region.
Nurse managers are often balancing large spans of control, she said, and as nurse managers lead staff, they simultaneously manage patients, throughput, quality, budgets and everyday issues. Advocate employs about 44,000 nurses and Dr. Dus leads 22,000 of them.
Over the last 18 months, Advocate asked its nurse managers, What do you do that you shouldn't be doing? What do you like to do? What's taking up your time?
"We know that they are our future leaders, so we stepped back and took time" to examine their roles, Dr. Dus told Becker's.
The questions revealed six untapped areas to help frontline leaders. These included defining scope and span of control, such as how many people report to them; managing pace of change; and minimizing the burden of onboarding.
The fourth focus was elevating nurses to practice at the top of their licenses, which involved removing tasks they shouldn't be doing, such as filling out repair skips or tracking down equipment, Dr. Dus said.
The final two areas of improvement were reviewing auditing processes and strengthening the partnership between nurses and the support department.
"The things that I'm most proud of is that we've aligned on standard scopes now that all our managers — assistant managers, managers, directors — have the same job descriptions, the same scopes, we're all doing the same job," Dr. Dus said.
From these discoveries, the system created a manager relief program, which is a float pool for nurses to "stretch" into a manager role for a few weeks or months to stabilize a unit.
Before, when a nurse manager left, another nurse manager of one unit would typically be assigned a second unit. Now, nurse managers can continue to focus on their own unit while a float nurse manager helps out until a permanent nurse manager is hired.
"That has been very successful," Dr. Dus said. "They do such a good job, but it's a really unique role, having these managers float around and fill in these open positions. It really just helps support our frontline managers."
Since discovering these opportunities and acting on them, Advocate has seen a decline in nurse manager turnover and a stabilization in staffing levels.
To continue to support its workforce, Advocate is piloting several AI models, including an ambient nurse listening pilot. Read more about how the system helps its frontline nurses with virtual nurse programs, here.