Investing in nurse leader development: Enhancing efficiency, quality, and financial performance

The past three years have presented numerous challenges for the healthcare industry, including high nurse turnover and the promotion of nurses into leadership roles without adequate training. This presents a challenge, seen and felt by many healthcare organizations, that new nurse managers do not have the knowledge, skills, and abilities to effectively lead and manage their departments. Management skills in nursing needed to excel as a nurse manager are distinct from those required for clinical nursing—being a successful bedside nurse doesn’t automatically translate into being a great nurse manager.

Why we need to invest in training new nurse managers

Nurse managers are the linchpins of their organizations—but many are ill-equipped to lead the front-line nursing staff without nurse manager training. A 2019 paper that I co-wrote for the Journal of Nursing Administration revealed that millennial nurse managers likely have less than four years of leadership experience—and when they step into these new  nurse manager roles, they are expected to learn as they go.

This means they must learn—on the fly—how to manage staffing levels, budget, allocate resources appropriately, mentor their nursing staff, and foster a culture of continuous learning, among other responsibilities. These expectations can be overwhelming for a new nurse manager. After all, business, human resources, and logistics skills weren’t taught in nursing school.

Unfortunately, research indicates that the onboarding and orientation programs for a new nurse manager are not standardized, and the variability in nurse manager training programs can make it difficult for new nurse leaders to acquire the necessary knowledge and skills to effectively lead and manage their departments.

The impact of high-performing nurse managers

According to data from Press Ganey’s National Database of Nursing Quality Indicators (NDNQI), high-performing nurse managers produce positive, healthy work environments. Our data shows that high-performing nurse managers have a positive impact on nurse retention and satisfaction. In fact, data suggests that nurses who perceive their managers as highly engaged and competent express a greater intent to stay and report increased job satisfaction.

In a recent analysis of Press Ganey’s NDNQI data, I worked with Press Ganey Data Analyst Jessica Myers to identify four impactful ways high-performing nurse managers drive engagement and nurse satisfaction. For this analysis, 524 nursing units were stratified according to unit performance on the nurse manager ability, leadership, and support subscale of the Practice Environment Scale (PES). All adult acute care units were included, and the top 10% (n=116) and lowest 10% (n=116) were retained for comparative analysis.

• Nurse manager ability and leadership support: Top-performing nurse managers scored 1.16 points higher on the nurse manager ability, leadership, and support subscale compared with bottom-performing managers.
• Intent to stay: Units with top-performing nurse managers had 32% more nurses reporting an intent to stay compared with units with bottom-performing managers.
• Nurse-reported Quality of Care (QOC): Units with top-performing nurse managers scored 3.59 out of 4 on the nurse-reported quality of care scale, while units with bottom-performing managers scored 2.91.
• Reduced missed nursing care activities: Units with top-performing nurse managers reported an average of 2.05 fewer missed nursing care activities, per nurse, per shift.

Moreover, high-performing nurse managers have been linked to better patient care and clinical outcomes, such as reduced falls, bloodstream infections, and urinary tract infections. On average, units with top-performing nurse managers report:

• 0.52 fewer falls per 1,000 patient days per unit, per year
• 0.33 fewer central line-associated blood stream infections (CLABSIs) per 1,000 patient days per unit, per year
• 0.37 fewer catheter-associated urinary tract infections (CAUTIs) per 1,000 patient days per unit, per year

The ROI of investing in nurse managers training

The cost of nurse turnover and poor clinical outcomes can have a substantial impact on a healthcare organization’s bottom line. When nurses leave their positions, organizations face expenses associated with the recruitment, hiring, and training of new staff members. The loss of experienced nurses can lead to poor clinical outcomes, such as preventable complications or errors—resulting in increased expenses.

We know that high-performing nurse managers have an impact on nurse engagement and retention and clinical outcomes. By investing in nurse manager training, hospitals can reduce turnover and clinical errors, and thus minimize the associated financial burdens.

For example, consider the following savings:

• The estimated cost of replacing a registered nurse is $52,350, according to data from NSI Nursing Solutions. In a unit of 50 RNs, if 32% more intend to stay because of their nurse manager, this results in an estimated savings of $837,000.
• On average, units with high-performing nurse managers report 0.52 fewer falls than units with low-performing nurse managers for an estimated annual savings of $3,480 per 1,000 patient days.
• On average, units with high-performing nurse managers report 0.33 fewer CLABSIs than units with low-performing nurse managers for an estimated annual savings of $15,875 per 1,000 patient days.
• On average, units with high-performing nurse managers report 0.37 fewer CAUTIs than units with low-performing nurse managers for an estimated annual savings of $5,100 per 1,000 patient days.

Press Ganey nursing consultants help nurse managers unlock their full potential

At Press Ganey, our team of nursing consultants is working every day to support nurses across all care settings. Press Ganey’s Nurse Leadership Development program is tailored to meet the unique demands placed on nurse managers. It offers a comprehensive curriculum—based on current national professional standards and competencies from the American Organization of Nursing Leaders (AONL) and the American Nurses Credentialing Center (ANCC)—that reinforces the necessary skills needed for success in leadership roles. But our Nurse Leadership Development program goes beyond the theoretical aspects of leadership—nurse managers learn practical skills to develop healthy relationships, foster a culture of accountability, and promote retention within their team.

The Nurse Leadership Development program is divided into three domains, each of which contains three modules. The most popular approaches for the program are:

1. Press Ganey-led training: Press Ganey’s team of expert nursing consultants experts will provide training to nurse managers over the course of several months.
2. Train-the-trainer: Press Ganey’s team of expert nursing consultants will train internal or organization leaders to then train their nurse managers. The organization can customize the curriculum to include specific elements or standards unique to the organization.
3. License only: Press Ganey will review the content with the organization, but the organization then moves forward alone with implementation.

Organizations that are utilizing Press Ganey’s Nurse Leadership Development program to train nurse managers have already seen improved outcomes and better staff engagement—and the nurse leaders feel better equipped to handle all the challenges that stand in their path.

To learn more about Press Ganey’s Nurse Leadership Development program and how we can help your organization’s nurse leaders thrive, reach out to our team of nurse experts.