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Nurses who teach lead best


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Alexandra Wilson Pecci, for HealthLeaders Media, October 16, 2012

In nursing, news and trends happening in other industries can slip under the radar. It's easy to see why. Healthcare is different in from other industries in various ways, from the heavy regulations, to complex work schedules, to the "life or death" circumstances that accompany every single workday.

But I recently read about a leadership study that merits attention from workers in every industry, including nursing.

A working paper from researchers at Stanford's Graduate School of Business and the University of Utah called "The Value of Bosses" finds that good front-line supervisors are directly correlated to worker productivity. Not only that, but study identified a trait that separates good bosses from poor ones: Teaching.

Researchers looked at workers in technology-based service jobs where computers measure their output every hour. Daily output was measured for 23,878 workers matched to 1,940 bosses over 5 years from 2006 to 2010, resulting in nearly 6 million measurements.

Each employee changed supervisors about four times a year, so researchers were able to tell which managers got better results from their workers.

Although the study was conducted among workers in the tech industry, the authors of the working paper say the results are relevant across industries. The results related to teaching might especially be applied to nursing because nurses are constantly acquiring new patient care skills, both on the job and via continuing education.

The research found that the average boss adds about 1.75 times as much output as the average worker. Teaching work skills or work habits accounts for two-thirds of the gain that bosses added. Moreover, the effect of good bosses on high-quality workers is greater than the effect of good bosses on lower-quality workers.

That suggests that the best bosses should be teamed with the best employees to achieve the best results, not the other way around.

The study also ranked managers by changes in productivity that occurred when they were added or removed from a team, as well as changes in productivity of workers who moved from one boss to another.

Replacing a low-performing boss with a high-performing boss raised productivity by 12%. Also, assigning a tenth worker to the team raised productivity about 11%. This finding is consistent with other nursing-related research which finds a higher nurse-patient ratio is associated with better outcomes.

For example, a study published over the summer in the American Journal of Infection Control found that hospitals with more nurses and lower patient-nurse ratios had fewer infections than hospitals with fewer nurses.

The effect of good nurse leaders can't be overstated, and this new study about high-quality bosses is only one piece of evidence to support that fact. It's something that it's my job to think about.

Earlier this month, I wrote about a study in the Journal of Applied Psychologywhich found that nurses are more likely to report patient-care errors when they feel safe admitting them to their supervisors. That, in turn, leads to a lower overall error rate and a stronger commitment to safety protocols.

Another recent study in the Journal of Nursing Scholarship, found that "when supported by their practice environments, nurses employ practices that can assist in interrupting medication errors before they reach the patients." A supportive practice environment was positively associated with error interception practices, and interception practices were, in turn, associated with lower medication error rates.

I could go on and on, citing study after study showing the importance of nurse leadership on healthcare quality, nursing satisfaction, and worker performance. But I won't. Instead, I'll just let you nurse leaders take the information and run with it.

Source: HealthLeaders Media