Managing Organizational Transitions: The Chief Nurse Perspective

Organizational change and transitions are a fact of life for healthcare agencies. Hospitals find themselves responding to rapid and unprecedented changes in the paradigm of healthcare delivery. As the external environment continues its volatility, how are chief nurses (chief nurse officers and chief nurse executives [CNO/Es]) responding as they provide major leadership within their institutions? The literature postulates a number of strategies for managing successful change, including involving the multidisciplinary team in developing change1 and a focus on transformational change to produce a fundamental change to how work was previously done.2 Leading and managing change is one of the leader's most important roles. Shirey3 argues that sustainable change strategies cannot be achieved unless the execution of the strategy is well understood by the leaders involved. A structured method for implementing organizational change or transition may be vital for success. Are nurse leaders using evidence-based management styles to achieve success at leading transition or change? There is a paucity of literature that describes how chief nurses (CNO/Es) lead organizational transition, as well as how effective those methods are. Using a structured interview guide based on Marks' work on facilitating adaptation to organizational transition,4 16 CNO/Es were surveyed to determine how they managed major change and transition within their organizations. These interviews were conducted between June and December of 2012.