Leadership / Management for QI Change (LFC) Among Chief Nurses in the USAPI Emi Chutaro, Executive Director PIHOA Kris Qureshi, PIHOA TA; Assoc. Prof of Nursing, UHM

LFC Program sponsor: International Council of Nursing (ICN) Key aims: Better equip chief nurses (and other middle managers) with the requisite leadership and management skills for effective management of health services Increase capacity for assessment, planning & implementation of improvements in quality care / services across all sectors of the health system

Background 04/13 request from PIHOA to form a working group of Chief Nurses (CN) to enhance PIHOA – CN engagement for the purpose of improving health services 06/13 APNLC meeting in Yap, FSM the bylaws were revised- formed the Chief Nurses Committee

Chief Nurse Committee - purpose and mission Purpose: “Work together to identify and address issues that impact capacity to efficiently and effectively deliver quality care to patients and populations in the hospital and public/community health settings across the US Affiliated Pacific Islands.” Mission: “Develop a system that supports quality nursing care that is cost effective and consistent with the health delivery system in their respective jurisdictions”

Identified two key priorities for action Identified two key priorities for action Leadership and management skill development among the CN Capacity to analyze nursing operations for the purpose of increasing efficiency, cost effectiveness and quality

Action taken Contacted the ICN, explored possibility of LFC program for chief nurses Arranged funding: variety of sources: PIHOA, UHM Nursing, reduced rate from ICN Program session #1 (of 3) scheduled for June 23-27, 2014, in Honolulu right after APNLC meeting

About the ICN LFC program The General objective of the program is to strengthen the capacity for nursing leadership and management so that: CN are better equipped to improve the quality of services and meet other critical challenges facing the health sector CN will help train others in a “second generation” program, thus enhancing the capacity for impact across the health care system.

LFC Program Methods Workshops: Core content - organization and management, resource utilization, nursing leadership and project planning, implementation and evaluation. Learning Activities: Many different learning activities are employed both during workshops and between workshops to develop the leadership and management skills Mentor: Each participant is required to identify a personal Mentor who will challenge and support their personal leadership and management development. Individual Development Plan: Each participant must develop and maintain an Individual Development Plan which is used to guide their personal leadership and management development. Team Projects: All participants will be in membership of Project Teams and will deliver a QI project by the end of the LFC program. The aim of the Team Projects is to a) change or improve some aspect of the health or nursing service

Logistics LFC program is delivered via 3 face to face sessions over the course of 9 months, with assigned work in home country between sessions Location: UH Manoa; housing EW Center PIHOA can fund one CN from each jurisdiction; for those that want to participate, the Minister / Director of Health will identify that participant The Minister/ Director may opt to send up to 2-3 additional participants, but will be required to support their travel and housing (marginal cost) for the additional participants The Minister/ Director will assign a senior level manager to serve as the on site mentor, and UH Manoa Nursing faculty will serve as distance based advisors in between sessions

Specific activities and deliverables Sessions in Honolulu, HI (n=3 one wk. sessions) In between sessions at home jurisdiction: ◦ On site mentor provides support, empowerment and encouragement ◦ CN forms/ leads an interdisciplinary team for a change for improvement project ◦ CN initiates on site training for others End of the program- concludes with train the trainer, CN expected to serve as a key trainer within the organization and mentor others going forward

Conclusion Nursing is the largest segment of the healthcare workforce and is a natural reservoir for program managers Basic nursing education in the most of the USAPI is technical in nature, and does not include leadership / or management Your CN pool has extensive institutional and local knowledge- cultivation of CN leadership and management potential coupled with empowerment will add significant capacity for moving health services forward across the region

Questions? Mahalo to PIHOA and the Ministers and Directors of Health for your ongoing efforts for the endeavor.