AONE Nurse Executive Competencies adopted by the Phoenix Area Council of
Nurse Administrators (PACONA) with permission of AONE.

**T**en years ago, the American Organization of Nurse Executives (AONE)
published its paper on the role and function of nurses in executive
practice. This document outlined the transitions occurring in healthcare
leadership and the dimensions and processes that were instrumental in
executive success. The AONE Board of Directors determined that it was
time to update this work with a more in-depth description of the
competencies integral to the practice of nurse executives. The
turbulent, ever-changing world of healthcare continues to present new
challenges. With its vision of "shaping the future of healthcare through
innovative nursing leadership," AONE recognizes that excellent
leadership is essential to ensure excellent patient care. The
competencies listed on these pages describe skills common to nurses in
executive practice regardless of their educational level or titles in
different organizations.

They are presented as information for both nurse leaders and those who
employ or work with them. Executives can use these competencies as a
self assessment tool, useful in the identification of possible areas for
growth. Aspiring nurse leaders can use them in planning personal
preparation for their careers. Healthcare organizations may see them as
a guideline for job descriptions, expectations and evaluations of nurse
leaders. Nurse educators can utilize them as a curriculum guideline for
the educational preparation of nurses seeking expertise and knowledge in
executive practice.

Chief Nurse Executive Competency

+--------------------------------------+---+---+---+---------------------+
| **\                                  | > | > | > | **Comments**        |
| Nurse Executive Competency Domains** |   |   |   |                     |
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|                                      |   | t | t |                     |
|                                      |   | a | i |                     |
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|                                      |   | e | * |                     |
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+--------------------------------------+---+---+---+---------------------+
| **1. Communication and               | [ | [ | [ | []{.mark}           |
| relationship-building**              | ] | ] | ] |                     |
|                                      | { | { | { |                     |
| > []{.mark}                          | . | . | . |                     |
|                                      | m | m | m |                     |
|                                      | a | a | a |                     |
|                                      | r | r | r |                     |
|                                      | k | k | k |                     |
|                                      | } | } | } |                     |
+--------------------------------------+---+---+---+---------------------+
| a. Effective Communication           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Make oral presentations to       |   |   |   |                     |
|     diverse audiences on nursing,    |   |   |   |                     |
|     healthcare, and organizational   |   |   |   |                     |
|     issues                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Produce cogent and persuasive    |   |   |   |                     |
|     written materials to address     |   |   |   |                     |
|     nursing, healthcare and          |   |   |   |                     |
|     organizational issues            |   |   |   |                     |
|     appropriate to the audience      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Resolve and manage conflict      |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| b. Relationship Management           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Build trusting, collaborative    |   |   |   |                     |
|     relationships with:              |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Staff                        |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Peers                        |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Other disciplines and        |   |   |   |                     |
|         ancillary services           |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Physicians Vendors           |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Community leaders            |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Nursing and other            |   |   |   |                     |
|         educational programs         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Deliver "bad news" in such a way |   |   |   |                     |
|     as to maintain credibility       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Follow through on promises and   |   |   |   |                     |
|     concerns                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Provide service recovery to      |   |   |   |                     |
|     dissatisfied customers           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Care about people as individuals |   |   |   |                     |
|     and demonstrate empathy and      |   |   |   |                     |
|     concern while ensuring that      |   |   |   |                     |
|     organizational goals and         |   |   |   |                     |
|     objectives are met               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Accomplish objectives through    |   |   |   |                     |
|     persuasion, celebrate successes  |   |   |   |                     |
|     and accomplishments, and         |   |   |   |                     |
|     communicate a shared vision      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Assert views in non-threatening, |   |   |   |                     |
|     non-judgmental ways              |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| c. Influencing Behaviors             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create and communicate a shared  |   |   |   |                     |
|     vision                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Reward appropriate behaviors and |   |   |   |                     |
|     confront and manage              |   |   |   |                     |
|     inappropriate behaviors          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop, communicate and monitor |   |   |   |                     |
|     behavior expectations            |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d. Diversity                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create an environment which      |   |   |   |                     |
|     recognizes and values            |   |   |   |                     |
|     differences in staff,            |   |   |   |                     |
|     physicians, patients and         |   |   |   |                     |
|     communities                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Assess current environment and   |   |   |   |                     |
|     establish indicators of progress |   |   |   |                     |
|     toward cultural competency       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Define diversity in terms of     |   |   |   |                     |
|     gender, race, religion,          |   |   |   |                     |
|     ethnicity, sexual orientation,   |   |   |   |                     |
|     age, etc.                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze population data to       |   |   |   |                     |
|     identify cultural clusters       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Define cultural competency and   |   |   |   |                     |
|     permeate principles throughout   |   |   |   |                     |
|     the organization                 |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Confront inappropriate behaviors |   |   |   |                     |
|     and attitudes toward diverse     |   |   |   |                     |
|     groups                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop processes to incorporate |   |   |   |                     |
|     cultural beliefs into care       |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| e.  Shared Decision-Making           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Engage staff and others in       |   |   |   |                     |
|     decision-making                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Promote decisions that are       |   |   |   |                     |
|     patient-centered                 |   |   |   |                     |
|                                      |   |   |   |                     |
| ```{=html}                           |   |   |   |                     |
| <!-- -->                             |   |   |   |                     |
| ```                                  |   |   |   |                     |
| -   Provide an environment conducive |   |   |   |                     |
|     to opinion-sharing               |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| f.  Community Involvement            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Represent the organization to    |   |   |   |                     |
|     non-healthcare constituents      |   |   |   |                     |
|     within the community             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Provide consultation to          |   |   |   |                     |
|     community and business leaders   |   |   |   |                     |
|     regarding nursing and health     |   |   |   |                     |
|     care                             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Be an effective board member for |   |   |   |                     |
|     community and/or professional    |   |   |   |                     |
|     organizations                    |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| g.  Medical Staff Relationships      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Build credibility with           |   |   |   |                     |
|     physicians as a champion for     |   |   |   |                     |
|     patient care, quality and        |   |   |   |                     |
|     nursing professionalism          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Confront and address             |   |   |   |                     |
|     inappropriate behavior towards   |   |   |   |                     |
|     patients and staff               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Represent nursing at medical     |   |   |   |                     |
|     executive committee and other    |   |   |   |                     |
|     medical staff committees         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with medical staff   |   |   |   |                     |
|     leaders in determining needed    |   |   |   |                     |
|     patient care services            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with physicians to   |   |   |   |                     |
|     develop patient care protocols,  |   |   |   |                     |
|     policies and procedures          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with physicians to   |   |   |   |                     |
|     determine patient care equipment |   |   |   |                     |
|     and facility needs               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Utilize medical staff mechanisms |   |   |   |                     |
|     to address physician clinical    |   |   |   |                     |
|     performance issues               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Facilitate disputes involving    |   |   |   |                     |
|     physicians and nurses or other   |   |   |   |                     |
|     disciplines                      |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| h.  Academic Relationships           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Determine current and future     |   |   |   |                     |
|     supply and demand for nursing    |   |   |   |                     |
|     care                             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Identify educational needs of    |   |   |   |                     |
|     existing and potential nursing   |   |   |   |                     |
|     staff                            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with nursing         |   |   |   |                     |
|     programs to provide required     |   |   |   |                     |
|     resources                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with nursing         |   |   |   |                     |
|     programs in evaluating quality   |   |   |   |                     |
|     of graduating clinicians and     |   |   |   |                     |
|     develop mechanisms to enhance    |   |   |   |                     |
|     this quality                     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Serve on academic advisory       |   |   |   |                     |
|     councils                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Collaborate with nursing faculty |   |   |   |                     |
|     in nursing research and          |   |   |   |                     |
|     incorporate nursing research     |   |   |   |                     |
|     into practice                    |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| **2. Knowledge of the Healthcare     |   |   |   |                     |
| Environment**                        |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| a.  Clinical Practice Knowledge      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Maintain knowledge of current    |   |   |   |                     |
|     nursing practice and the roles   |   |   |   |                     |
|     and functions of patient care    |   |   |   |                     |
|     team members                     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate patient care          |   |   |   |                     |
|     standards as published by JCAHO, |   |   |   |                     |
|     CMS, AAAHC and professional      |   |   |   |                     |
|     nursing literature               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Understand, articulate, and      |   |   |   |                     |
|     ensure compliance with the State |   |   |   |                     |
|     Nurse Practice Act, State Board  |   |   |   |                     |
|     of Nursing regulations,          |   |   |   |                     |
|     regulatory agency standards, and |   |   |   |                     |
|     policies of the organization     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Ensure that written organization |   |   |   |                     |
|     clinical policies and procedures |   |   |   |                     |
|     are reviewed and updated in      |   |   |   |                     |
|     accordance with evidence-based   |   |   |   |                     |
|     practice                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Role model lifelong learning,    |   |   |   |                     |
|     including clinical subjects such |   |   |   |                     |
|     as disease processes,            |   |   |   |                     |
|     pharmaceuticals, and clinical    |   |   |   |                     |
|     technology                       |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| b.  Delivery Models/Work Design      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Maintain current knowledge of    |   |   |   |                     |
|     patient care delivery systems    |   |   |   |                     |
|     and innovations                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate various delivery      |   |   |   |                     |
|     systems and patient care models  |   |   |   |                     |
|     and the advantages/disadvantages |   |   |   |                     |
|     of each                          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Serve as change agent when       |   |   |   |                     |
|     patient care work/workflow is    |   |   |   |                     |
|     redesigned                       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Determine when new delivery      |   |   |   |                     |
|     models are appropriate, and then |   |   |   |                     |
|     envision and develop them        |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| c\. Healthcare Economics             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate federal and state     |   |   |   |                     |
|     payment systems and regulations, |   |   |   |                     |
|     as well as private insurance     |   |   |   |                     |
|     issues, which affect             |   |   |   |                     |
|     organization's finances          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Understand and articulate        |   |   |   |                     |
|     individual organization's payer  |   |   |   |                     |
|     mix, CMI and benchmark database  |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d\. Healthcare Policy                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate federal and state     |   |   |   |                     |
|     laws and regulations that affect |   |   |   |                     |
|     the provision of patient care,   |   |   |   |                     |
|     e.g., tort reform,               |   |   |   |                     |
|     malpractice/negligence,          |   |   |   |                     |
|     reimbursement                    |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in the legislative   |   |   |   |                     |
|     process concerning health care   |   |   |   |                     |
|     through membership in            |   |   |   |                     |
|     professional organization and    |   |   |   |                     |
|     personal contact with public     |   |   |   |                     |
|     officials                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Educate patient care team        |   |   |   |                     |
|     members on the legislative and   |   |   |   |                     |
|     regulatory processes and methods |   |   |   |                     |
|     for influencing both             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Interpret impact of state and    |   |   |   |                     |
|     federal legislation on nursing   |   |   |   |                     |
|     and health care organizations    |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| e\. Governance                       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate the role of the       |   |   |   |                     |
|     governing body of the            |   |   |   |                     |
|     organization in the following    |   |   |   |                     |
|     areas:                           |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Fiduciary responsibilities   |   |   |   |                     |
|         (Fiduciary: person standing  |   |   |   |                     |
|         in a special relationship of |   |   |   |                     |
|         trust, confidence, or        |   |   |   |                     |
|         responsibility to another)   |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Credentialing                |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Performance management       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Represent patient care issues to |   |   |   |                     |
|     the governing body               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in strategic         |   |   |   |                     |
|     planning and quality initiative  |   |   |   |                     |
|     with the governing body          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Interact with and educate the    |   |   |   |                     |
|     organization's board members     |   |   |   |                     |
|     regarding healthcare and the     |   |   |   |                     |
|     value of nursing care            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Represent nursing at the         |   |   |   |                     |
|     organization's board meetings    |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| f\. Evidence-Based Practice/Outcome  |   |   |   |                     |
| Measurement                          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Interpret information from       |   |   |   |                     |
|     research                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Utilize research findings for    |   |   |   |                     |
|     the establishment of standards,  |   |   |   |                     |
|     practices, and patient care      |   |   |   |                     |
|     models in the organization       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Disseminate research findings to |   |   |   |                     |
|     patient care team members        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in studies that      |   |   |   |                     |
|     provide outcome measurements     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Allocate nursing resources based |   |   |   |                     |
|     on measurement of patient        |   |   |   |                     |
|     acuity/care needed               |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| g\. Patient Safety                   |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Support the development and      |   |   |   |                     |
|     implementation of an             |   |   |   |                     |
|     organization-wide patient safety |   |   |   |                     |
|     program                          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Design safe clinical systems,    |   |   |   |                     |
|     processes, policies and          |   |   |   |                     |
|     procedures                       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Monitor clinical activities to   |   |   |   |                     |
|     identify both expected and       |   |   |   |                     |
|     unexpected risks                 |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Support a non-punitive reporting |   |   |   |                     |
|     environment and a reward system  |   |   |   |                     |
|     for reporting unsafe practices   |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Support safety surveys,          |   |   |   |                     |
|     responding and acting on safety  |   |   |   |                     |
|     recommendations                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Ensure staff is clinically       |   |   |   |                     |
|     competent and trained on their   |   |   |   |                     |
|     role in patient safety           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate and take action to    |   |   |   |                     |
|     support the JCAHO National       |   |   |   |                     |
|     Patient Safety Goals             |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| h\. Utilization/Case Management      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate organization          |   |   |   |                     |
|     decision-making for the criteria |   |   |   |                     |
|     model adopted by the             |   |   |   |                     |
|     organization                     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Communicate key points of the    |   |   |   |                     |
|     model to a variety of audiences  |   |   |   |                     |
|     (nursing, financial, medical     |   |   |   |                     |
|     staff)                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Involve physicians in on-going   |   |   |   |                     |
|     utilization management practices |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Design continuum of care options |   |   |   |                     |
|     for managing patient throughput  |   |   |   |                     |
|     (long term care units, urgent    |   |   |   |                     |
|     care centers,                    |   |   |   |                     |
|     admission/discharge units, etc.) |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| i\. Quality Improvement/Metrics      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate the organization's QI |   |   |   |                     |
|     program and goals                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Determine patient care quality   |   |   |   |                     |
|     improvement goals and objectives |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Define metrics as related to     |   |   |   |                     |
|     process improvement              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Explain and utilize metrics as a |   |   |   |                     |
|     unit of measure for any process  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate the link between      |   |   |   |                     |
|     metrics and goals                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate the link between      |   |   |   |                     |
|     organization metrics and         |   |   |   |                     |
|     national quality                 |   |   |   |                     |
|     initiatives/metrics              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Target outcomes that are         |   |   |   |                     |
|     evidence-based (comparison data  |   |   |   |                     |
|     (benchmarking)                   |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Define Quality metrics by:       |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Identifying the              |   |   |   |                     |
|         problem/process              |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Measuring success at         |   |   |   |                     |
|         improving specific areas of  |   |   |   |                     |
|         patient care                 |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Analyzing the root causes or |   |   |   |                     |
|         variation from quality       |   |   |   |                     |
|         standards                    |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Improving the process with   |   |   |   |                     |
|         the evidence                 |   |   |   |                     |
|                                      |   |   |   |                     |
|     -   Controlling solutions and    |   |   |   |                     |
|         sustaining success           |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| j\. Risk Management                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Identify areas of risk/liability |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Ensure staff is educated on risk |   |   |   |                     |
|     management and compliance issues |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop systems which            |   |   |   |                     |
|     encourage/require prompt         |   |   |   |                     |
|     reporting of potential liability |   |   |   |                     |
|     by staff at all levels           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Envision and take action to      |   |   |   |                     |
|     correct identified areas of      |   |   |   |                     |
|     potential liability              |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| **III. Leadership**                  |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| a\. Foundational Thinking Skills     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Address ideas, beliefs or        |   |   |   |                     |
|     viewpoints that should be given  |   |   |   |                     |
|     serious consideration            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Recognize one's own method of    |   |   |   |                     |
|     decision making and the role of  |   |   |   |                     |
|     beliefs, values and inferences   |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Critically analyze               |   |   |   |                     |
|     organizational issues after a    |   |   |   |                     |
|     review of the evidence           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Maintain curiosity and an        |   |   |   |                     |
|     eagerness to explore new         |   |   |   |                     |
|     knowledge and ideas              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Promote nursing leadership as    |   |   |   |                     |
|     both a science and an art        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Demonstrate reflective           |   |   |   |                     |
|     leadership and an understanding  |   |   |   |                     |
|     that all leadership begins from  |   |   |   |                     |
|     within                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Provide visionary thinking on    |   |   |   |                     |
|     issues that impact the           |   |   |   |                     |
|     healthcare organization          |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| b\. Personal Journey Disciplines     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Value and act on feedback that   |   |   |   |                     |
|     is provided about one's own      |   |   |   |                     |
|     strengths and weaknesses         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Demonstrate the value of         |   |   |   |                     |
|     lifelong learning through one's  |   |   |   |                     |
|     own example                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Learn from setbacks and failures |   |   |   |                     |
|     as well as successes             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Assess one's personal,           |   |   |   |                     |
|     professional and career goals    |   |   |   |                     |
|     and undertake career planning    |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Seek mentorship from respected   |   |   |   |                     |
|     colleagues                       |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| c\. Systems Thinking                 |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Promote systems thinking as a    |   |   |   |                     |
|     value in the nursing             |   |   |   |                     |
|     organization                     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Consider the impact of nursing   |   |   |   |                     |
|     decisions on the health care     |   |   |   |                     |
|     organization as a whole          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Provide leadership in building   |   |   |   |                     |
|     loyalty and commitment           |   |   |   |                     |
|     throughout the organization      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Synthesize and integrate         |   |   |   |                     |
|     divergent viewpoints for the     |   |   |   |                     |
|     good of the organization         |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d\. Succession Planning              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Promote nursing management as a  |   |   |   |                     |
|     desirable specialty              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Conduct periodic organizational  |   |   |   |                     |
|     assessments to identify          |   |   |   |                     |
|     succession planning issues and   |   |   |   |                     |
|     establish action plans           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Serve as a professional role     |   |   |   |                     |
|     model and mentor to future       |   |   |   |                     |
|     nursing leaders                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Establish mechanisms that        |   |   |   |                     |
|     provide for early identification |   |   |   |                     |
|     and mentoring of staff with      |   |   |   |                     |
|     leadership potential             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop a succession plan for    |   |   |   |                     |
|     one's own position               |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| e\. Change Management                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Utilize change theory to plan    |   |   |   |                     |
|     for the implementation of        |   |   |   |                     |
|     organizational changes           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Serve as a change agent,         |   |   |   |                     |
|     assisting others in              |   |   |   |                     |
|     understanding the importance,    |   |   |   |                     |
|     necessity, impact and process of |   |   |   |                     |
|     change                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Support staff during times of    |   |   |   |                     |
|     difficult transitions            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Recognize one's own reaction to  |   |   |   |                     |
|     change and strive to remain open |   |   |   |                     |
|     to new ideas and approaches      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Adapt leadership style to        |   |   |   |                     |
|     situational needs                |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| **IV. Professionalism**              |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| a\. Personal and Professional        |   |   |   |                     |
| Accountability                       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create an environment that       |   |   |   |                     |
|     facilitates the team to initiate |   |   |   |                     |
|     actions that produce results     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Hold self and others accountable |   |   |   |                     |
|     for actions and outcomes         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create an environment in which   |   |   |   |                     |
|     others are setting expectations  |   |   |   |                     |
|     and holding each other           |   |   |   |                     |
|     accountable                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Answer for the results of one's  |   |   |   |                     |
|     own behaviors and actions        |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| b\. Career Planning                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop own career plan and      |   |   |   |                     |
|     measure progress according to    |   |   |   |                     |
|     that plan                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Coach others in developing their |   |   |   |                     |
|     own career plans                 |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create an environment in which   |   |   |   |                     |
|     professional and personal growth |   |   |   |                     |
|     is an expectation                |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| c\. Ethics                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate the application of    |   |   |   |                     |
|     ethical principles to operations |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Integrate high ethical standards |   |   |   |                     |
|     and core values into everyday    |   |   |   |                     |
|     work activities                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create an environment that has a |   |   |   |                     |
|     reputation for high ethical      |   |   |   |                     |
|     standards                        |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d\. Evidence-Based Clinical and      |   |   |   |                     |
| Management Practice                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Advocate use of documented best  |   |   |   |                     |
|     practices                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Teach and mentor others to       |   |   |   |                     |
|     routinely utilize evidence-based |   |   |   |                     |
|     data and research                |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| e\. Advocacy                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Role model the perspective that  |   |   |   |                     |
|     patient care is the core of the  |   |   |   |                     |
|     organization's work              |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Assure that the clinical         |   |   |   |                     |
|     perspective is included in       |   |   |   |                     |
|     organizational decisions         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Ensure that nurses are actively  |   |   |   |                     |
|     involved in decisions that       |   |   |   |                     |
|     affect their practice            |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| f\. Active Membership in             |   |   |   |                     |
| Professional Organizations           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in at least one      |   |   |   |                     |
|     professional organization        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Support and encourage others to  |   |   |   |                     |
|     participate in a professional    |   |   |   |                     |
|     organization                     |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| **V. Business Skills**               |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| a\. Financial Management             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Articulate business models for   |   |   |   |                     |
|     healthcare organizations and     |   |   |   |                     |
|     fundamental concepts of          |   |   |   |                     |
|     economics                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Describe general accounting      |   |   |   |                     |
|     principles and define basic      |   |   |   |                     |
|     accounting terms                 |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze financial statements     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Manage financial resources by    |   |   |   |                     |
|     developing business plans        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Establish procedures to assure   |   |   |   |                     |
|     accurate charging mechanisms     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Educate patient care team        |   |   |   |                     |
|     members on financial             |   |   |   |                     |
|     implications of patient care     |   |   |   |                     |
|     decisions                        |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| b\. Human Resource Management        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in workforce         |   |   |   |                     |
|     planning and employment          |   |   |   |                     |
|     decisions                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Champion a diverse workforce     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use corrective discipline to     |   |   |   |                     |
|     mitigate workplace behavior      |   |   |   |                     |
|     problems                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Interpret and evaluate employee  |   |   |   |                     |
|     satisfaction/quality of work     |   |   |   |                     |
|     surveys                          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Create opportunities for         |   |   |   |                     |
|     employees to be involved in      |   |   |   |                     |
|     decision-making                  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Reward and recognize exemplary   |   |   |   |                     |
|     performance                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Formulate programs to enhance    |   |   |   |                     |
|     work-life balance                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Interpret legal and regulatory   |   |   |   |                     |
|     guidelines                       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Manage collective bargaining     |   |   |   |                     |
|     environments or implement        |   |   |   |                     |
|     programs to avoid the need       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Identify and eliminate sexual    |   |   |   |                     |
|     harassment, workplace violence,  |   |   |   |                     |
|     and verbal and physical abuse    |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Implement ergonomically sound    |   |   |   |                     |
|     work environments to prevent     |   |   |   |                     |
|     worker injury and fatigue        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop and implement            |   |   |   |                     |
|     bioterrorism, biohazard and      |   |   |   |                     |
|     disaster readiness plans         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Identify clinical and leadership |   |   |   |                     |
|     skills necessary for performing  |   |   |   |                     |
|     job-related tasks                |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Select top talent, matching      |   |   |   |                     |
|     organizational needs with        |   |   |   |                     |
|     appropriate skill sets (assess   |   |   |   |                     |
|     job candidate skills sets)       |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Manage performance through       |   |   |   |                     |
|     rewards, recognition, counseling |   |   |   |                     |
|     and disciplinary action          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Provide mentorship and career    |   |   |   |                     |
|     counseling to aspiring           |   |   |   |                     |
|     clinicians and leaders so they   |   |   |   |                     |
|     may develop required skill sets  |   |   |   |                     |
|     (succession planning)            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Identify future skill sets       |   |   |   |                     |
|     needed to remain competitive     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze market data in relation  |   |   |   |                     |
|     to supply and demand and manage  |   |   |   |                     |
|     resources to ensure appropriate  |   |   |   |                     |
|     compensation                     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop and implement            |   |   |   |                     |
|     recruitment and retention        |   |   |   |                     |
|     strategies                       |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| c\. Strategic Management             |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze the situation and        |   |   |   |                     |
|     identify strategic direction     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Conduct SWOT and gap analyses    |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Formulate objectives, goals, and |   |   |   |                     |
|     specific strategies related to   |   |   |   |                     |
|     mission and vision               |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Understand what organizations    |   |   |   |                     |
|     should measure in order to       |   |   |   |                     |
|     "balance" the financial          |   |   |   |                     |
|     perspective                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Measure and analyze performance  |   |   |   |                     |
|     from the learning and growth,    |   |   |   |                     |
|     business process, customer, and  |   |   |   |                     |
|     financial perspectives           |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d\. Marketing                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze marketing opportunities  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop marketing strategies     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Integrate marketing and          |   |   |   |                     |
|     communications strategies        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use public relations and media   |   |   |   |                     |
|     outlets to promote your          |   |   |   |                     |
|     organization                     |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| d\. Marketing                        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Analyze marketing opportunities  |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Develop marketing strategies     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Integrate marketing and          |   |   |   |                     |
|     communications strategies        |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use public relations and media   |   |   |   |                     |
|     outlets to promote your          |   |   |   |                     |
|     organization                     |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+
| e\. Information Management and       |   |   |   |                     |
| Technology                           |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Demonstrate basic competency in  |   |   |   |                     |
|     e-mail, common word processing,  |   |   |   |                     |
|     spreadsheet, and Internet        |   |   |   |                     |
|     programs                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Recognize the relevance of       |   |   |   |                     |
|     nursing data for improving       |   |   |   |                     |
|     practice                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Recognize limitations of         |   |   |   |                     |
|     computer applications            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use telecommunication devices    |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Utilize hospital database        |   |   |   |                     |
|     management, decision support,    |   |   |   |                     |
|     and expert system programs to    |   |   |   |                     |
|     access information and analyze   |   |   |   |                     |
|     data from disparate sources for  |   |   |   |                     |
|     use in planning for patient care |   |   |   |                     |
|     processes and systems            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in system change     |   |   |   |                     |
|     processes and utility analysis   |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Participate in the evaluation of |   |   |   |                     |
|     information systems in practice  |   |   |   |                     |
|     settings                         |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Evaluate and revise patient care |   |   |   |                     |
|     processes and systems            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use computerized management      |   |   |   |                     |
|     systems to record administrative |   |   |   |                     |
|     data (billing data, quality      |   |   |   |                     |
|     assurance data, workload data,   |   |   |   |                     |
|     etc.)                            |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Use applications for structured  |   |   |   |                     |
|     data entry (classification       |   |   |   |                     |
|     systems, acuity level, etc.)     |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Recognize the utility of nursing |   |   |   |                     |
|     involvement in the planning,     |   |   |   |                     |
|     design, choice and               |   |   |   |                     |
|     implementation of information    |   |   |   |                     |
|     systems in the practice          |   |   |   |                     |
|     environment                      |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Demonstrate awareness of         |   |   |   |                     |
|     societal and technological       |   |   |   |                     |
|     trends, issues and new           |   |   |   |                     |
|     developments as they apply to    |   |   |   |                     |
|     nursing                          |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Demonstrate proficient awareness |   |   |   |                     |
|     of legal and ethical issues      |   |   |   |                     |
|     related to client data,          |   |   |   |                     |
|     information, and confidentiality |   |   |   |                     |
|                                      |   |   |   |                     |
| -   Read and interpret benchmarking, |   |   |   |                     |
|     financial and occupancy data     |   |   |   |                     |
+--------------------------------------+---+---+---+---------------------+