LWW/NAQ
NAQ-D-14-00034
September 4, 2014
3:43
Nurs Admin Q Vol. 38, No. 4, pp. 356–358 c 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright
News From the Front
Using Philanthropy to Enhance Nursing Presence The Cleveland Clinic Experience Kelly Hancock, MSN, RN, NE-BC; Randall Steven Hudspeth, PhD, MS, APRN-CNP/CNS, FRE, FAANP
C
HIEF NURSING OFFICERS (CNOs) are challenged in today’s health care economic climate to be more innovative in the ways they fund and manage providing a comprehensive and unified nursing presence within an organization. When organizational structures change and nursing reporting relationships are altered or distributed in a matrix format across an organization, the common bonds that tie nursing staff together need to continue and oftentimes to be strengthened. This is difficult for the CNO who can be faced with decreased financial resources and competing priorities among nursing stakeholders. This column describes the experience at the Cleveland Clinic in Cleveland, Ohio. Nursing has had a traditional presence at the clinic since its founding in 1922, and the clinic enjoys a reputation for medical innovation and top-quality medical care. Nurse and physician relationships have historically been good, and
Author Affiliation: Cleveland Clinic Health System, Cleveland, Ohio (Ms Kelly), and Cleveland Clinic Abu Dhabi/Cleveland Clinic International Operations, Abu Dhabi, United Arab Emirates (Dr Hudspeth). The authors declare no conflict of interest. Correspondence: Randall Steven Hudspeth, PhD, MS, APRN-CNP/CNS, FRE, FAANP, Cleveland Clinic Abu Dhabi, Sowwah Square, Al Maryah Island, Abu Dhabi, United Arab Emirates ([email protected]) DOI: 10.1097/NAQ.0000000000000065
highly competent nursing care contributed to the overall reputation of the clinic. During the 2000s, the clinic completed an organization restructure plan that defined specific medically focused institutes that partnered a physician leader with an institute nursing director and an institute business administrator. Both the nursing director and the institute administrator were given a direct reporting relationship to the institute physician chief. The administrator was matrixed to the overall clinic business administration, and the nursing director matrixed to the overall clinic CNO. At the same time, all 14 hospitals owned or operated by the Cleveland Clinic became part of the Cleveland Clinic Health System and the CNO at the main campus became the executive CNO for the system. Operational funding remained a negotiated effort between central administration and the institutes. Funding for what had been centralized nursing functions became distributed. While there was no significant decrease or change in the amount of training dollars available, and the institutes had more individual control, programs that applied to systemwide nursing issues became harder to fund and manage. Beyond the professional boundaries of nursing itself, nursing has been historically viewed as a cost by others. It has often been the first target when cuts are called for to meet financial goals. To maintain staffing levels and to meet the basic needs of a nursing service,
356 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ
NAQ-D-14-00034
September 4, 2014
3:43
Using Philanthropy to Enhance Nursing Presence commonly the “nice to haves” are sacrificed. The CNO had to look beyond traditional methods of reorganization, work redistribution, and the formation of new partnerships within the organization to find funding for continuing to provide a broad spectrum of services. These services were needed to engage professional nurses, decrease employment costs of turnover, stimulate a positive morale among staff, and impact the reputation of the facility as a positive place where quality nursing care is delivered. Important to the CNO was finding answers to these questions: How can more be done with less? How can a facility not lose what has been previously achieved? What resources can be discovered that will provide increased independence to maintain a positive trajectory? One of the first nursing leadership strategies was to position nursing on the same level as other clinical professions by forming the Nursing Institute and defining reporting relationships. The Cleveland Clinic has almost 40 000 employees, with nearly 11 000 registered nurses, 900 advanced practice registered nurses, and additional support staff who comprise the Nursing Institute. They practice on more than 40 specialty-based nursing units. One unintended consequence of organizational restructure and decentralization was the loss of some common dependencies. This happened because funding sources were sometimes no longer centralized and thus not available to support global service needs. Competing priorities emerged and presented resource conflicts in addition to the control of personnel resources being disseminated among multiple stakeholders. To mitigate the negative unintended outcomes, the executive CNO for Cleveland Clinic Health System sought philanthropic funds to sustain the ongoing needs of a disseminated nursing service. Philanthropy means “love of humanity” in the sense of caring, nourishing, developing, and enhancing what it is to be human. Traditionally, the use of philanthropy has been the role of foundation office professionals. They control contacts, marketing, and strat-
357
egy; they usually facilitate “the ask.” Among those who frequent the philanthropy world, there is a known set of skills in managing “the ask.” These include identification of variables that are important to the donor and that can either destroy or “seal the deal.” Sometimes, offers of donations come without an organizational ask because those who have been served are grateful and made generous gifts so that others may benefit from care like they did. Gratefulness and generosity are what drove the endowment of the Cleveland Clinic Nursing Institute. The endowment gift was given by a patient who had a love for humanity and a love for nursing. Stanley Shalom Zielony, who died in August 2012, was the president of a publishing company in Long Island, New York. His original gift in late 2008 to the clinic’s Nursing Institute established the Stanley S. Zielony Center for Advanced Nursing Education. The center was designated to enhance educational resources, provide tuition scholarships, and boost technology that enabled real-time learning for nurses. The clinic purchased a number of untethered human patient simulators because the simulators used by the clinic at that time had to be tethered to an air compressor that aided in breathing simulation, which limited their use. The benefits from the original gift prompted Mr Zielony to make a significant and larger contribution in November 2009. At that time he said, As a patient of Cleveland Clinic I was impressed by the efficiency and innovation of the staff, especially the nurses. With my first gift, I saw sparks fly as the education center took off. Now the institute is poised to focus on nursing excellence from all aspects. I really want to give nurses more opportunity and I believe Cleveland Clinic is the right place for it.
Mr Zielony had certain restrictions for his gift. Some funds were dedicated to specific areas, including nursing innovation, education (including a tuition assistance program), nursing research development, and other strategies that would continue to elevate the profession of nursing. The CNO worked with him to
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ
358
NAQ-D-14-00034
September 4, 2014
3:43
NURSING ADMINISTRATION QUARTERLY/OCTOBER–DECEMBER 2014
establish an endowed nursing chair position that was initially held by the executive CNO. As a result of the donation, the clinic’s Nursing Institute was renamed in Zielony’s honor to be the Stanley Shalom Zielony Institute for Nursing Excellence. The Cleveland Clinic recognized Mr Zielony further for his many generous contributions by naming the building that formerly housed the Health Space Museum to be named the Stanley Shalom Zielony Plaza. One outcome of this type of gift is the development of the next generation of nurses who will shape health care for the future. The Stanley Shalom Zielony Institute for Nursing Excellence has seen the Cleveland Clinic
receive its third Magnet designation. More than 25% of the nursing staff has at least one national certification, and the clinic’s percentage of minority nurses continues to increase. The number of registered nurses with a BSN degree continues to increase, and nursing employee engagement and patient experience scores have both risen every year. The Stanley Shalom Zielony Institute for Nursing Excellence continues to seek philanthropic resources to support nursing, but the initial gift from Mr Zielony established a basis for continued growth and future improvement. It is a stellar example of what philanthropy can do for nurses and for those who receive their care.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
NAQ-D-14-00034
September 4, 2014
3:43
Nurs Admin Q Vol. 38, No. 4, pp. 356–358 c 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Copyright
News From the Front
Using Philanthropy to Enhance Nursing Presence The Cleveland Clinic Experience Kelly Hancock, MSN, RN, NE-BC; Randall Steven Hudspeth, PhD, MS, APRN-CNP/CNS, FRE, FAANP
C
HIEF NURSING OFFICERS (CNOs) are challenged in today’s health care economic climate to be more innovative in the ways they fund and manage providing a comprehensive and unified nursing presence within an organization. When organizational structures change and nursing reporting relationships are altered or distributed in a matrix format across an organization, the common bonds that tie nursing staff together need to continue and oftentimes to be strengthened. This is difficult for the CNO who can be faced with decreased financial resources and competing priorities among nursing stakeholders. This column describes the experience at the Cleveland Clinic in Cleveland, Ohio. Nursing has had a traditional presence at the clinic since its founding in 1922, and the clinic enjoys a reputation for medical innovation and top-quality medical care. Nurse and physician relationships have historically been good, and
Author Affiliation: Cleveland Clinic Health System, Cleveland, Ohio (Ms Kelly), and Cleveland Clinic Abu Dhabi/Cleveland Clinic International Operations, Abu Dhabi, United Arab Emirates (Dr Hudspeth). The authors declare no conflict of interest. Correspondence: Randall Steven Hudspeth, PhD, MS, APRN-CNP/CNS, FRE, FAANP, Cleveland Clinic Abu Dhabi, Sowwah Square, Al Maryah Island, Abu Dhabi, United Arab Emirates ([email protected]) DOI: 10.1097/NAQ.0000000000000065
highly competent nursing care contributed to the overall reputation of the clinic. During the 2000s, the clinic completed an organization restructure plan that defined specific medically focused institutes that partnered a physician leader with an institute nursing director and an institute business administrator. Both the nursing director and the institute administrator were given a direct reporting relationship to the institute physician chief. The administrator was matrixed to the overall clinic business administration, and the nursing director matrixed to the overall clinic CNO. At the same time, all 14 hospitals owned or operated by the Cleveland Clinic became part of the Cleveland Clinic Health System and the CNO at the main campus became the executive CNO for the system. Operational funding remained a negotiated effort between central administration and the institutes. Funding for what had been centralized nursing functions became distributed. While there was no significant decrease or change in the amount of training dollars available, and the institutes had more individual control, programs that applied to systemwide nursing issues became harder to fund and manage. Beyond the professional boundaries of nursing itself, nursing has been historically viewed as a cost by others. It has often been the first target when cuts are called for to meet financial goals. To maintain staffing levels and to meet the basic needs of a nursing service,
356 Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ
NAQ-D-14-00034
September 4, 2014
3:43
Using Philanthropy to Enhance Nursing Presence commonly the “nice to haves” are sacrificed. The CNO had to look beyond traditional methods of reorganization, work redistribution, and the formation of new partnerships within the organization to find funding for continuing to provide a broad spectrum of services. These services were needed to engage professional nurses, decrease employment costs of turnover, stimulate a positive morale among staff, and impact the reputation of the facility as a positive place where quality nursing care is delivered. Important to the CNO was finding answers to these questions: How can more be done with less? How can a facility not lose what has been previously achieved? What resources can be discovered that will provide increased independence to maintain a positive trajectory? One of the first nursing leadership strategies was to position nursing on the same level as other clinical professions by forming the Nursing Institute and defining reporting relationships. The Cleveland Clinic has almost 40 000 employees, with nearly 11 000 registered nurses, 900 advanced practice registered nurses, and additional support staff who comprise the Nursing Institute. They practice on more than 40 specialty-based nursing units. One unintended consequence of organizational restructure and decentralization was the loss of some common dependencies. This happened because funding sources were sometimes no longer centralized and thus not available to support global service needs. Competing priorities emerged and presented resource conflicts in addition to the control of personnel resources being disseminated among multiple stakeholders. To mitigate the negative unintended outcomes, the executive CNO for Cleveland Clinic Health System sought philanthropic funds to sustain the ongoing needs of a disseminated nursing service. Philanthropy means “love of humanity” in the sense of caring, nourishing, developing, and enhancing what it is to be human. Traditionally, the use of philanthropy has been the role of foundation office professionals. They control contacts, marketing, and strat-
357
egy; they usually facilitate “the ask.” Among those who frequent the philanthropy world, there is a known set of skills in managing “the ask.” These include identification of variables that are important to the donor and that can either destroy or “seal the deal.” Sometimes, offers of donations come without an organizational ask because those who have been served are grateful and made generous gifts so that others may benefit from care like they did. Gratefulness and generosity are what drove the endowment of the Cleveland Clinic Nursing Institute. The endowment gift was given by a patient who had a love for humanity and a love for nursing. Stanley Shalom Zielony, who died in August 2012, was the president of a publishing company in Long Island, New York. His original gift in late 2008 to the clinic’s Nursing Institute established the Stanley S. Zielony Center for Advanced Nursing Education. The center was designated to enhance educational resources, provide tuition scholarships, and boost technology that enabled real-time learning for nurses. The clinic purchased a number of untethered human patient simulators because the simulators used by the clinic at that time had to be tethered to an air compressor that aided in breathing simulation, which limited their use. The benefits from the original gift prompted Mr Zielony to make a significant and larger contribution in November 2009. At that time he said, As a patient of Cleveland Clinic I was impressed by the efficiency and innovation of the staff, especially the nurses. With my first gift, I saw sparks fly as the education center took off. Now the institute is poised to focus on nursing excellence from all aspects. I really want to give nurses more opportunity and I believe Cleveland Clinic is the right place for it.
Mr Zielony had certain restrictions for his gift. Some funds were dedicated to specific areas, including nursing innovation, education (including a tuition assistance program), nursing research development, and other strategies that would continue to elevate the profession of nursing. The CNO worked with him to
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
LWW/NAQ
358
NAQ-D-14-00034
September 4, 2014
3:43
NURSING ADMINISTRATION QUARTERLY/OCTOBER–DECEMBER 2014
establish an endowed nursing chair position that was initially held by the executive CNO. As a result of the donation, the clinic’s Nursing Institute was renamed in Zielony’s honor to be the Stanley Shalom Zielony Institute for Nursing Excellence. The Cleveland Clinic recognized Mr Zielony further for his many generous contributions by naming the building that formerly housed the Health Space Museum to be named the Stanley Shalom Zielony Plaza. One outcome of this type of gift is the development of the next generation of nurses who will shape health care for the future. The Stanley Shalom Zielony Institute for Nursing Excellence has seen the Cleveland Clinic
receive its third Magnet designation. More than 25% of the nursing staff has at least one national certification, and the clinic’s percentage of minority nurses continues to increase. The number of registered nurses with a BSN degree continues to increase, and nursing employee engagement and patient experience scores have both risen every year. The Stanley Shalom Zielony Institute for Nursing Excellence continues to seek philanthropic resources to support nursing, but the initial gift from Mr Zielony established a basis for continued growth and future improvement. It is a stellar example of what philanthropy can do for nurses and for those who receive their care.
Copyright © 2014 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.
