Chief Nursing Officer - CNO - Adult Services

The Chief Nursing Officer (CNO) is a senior executive responsible for the strategic and operational leadership of nursing care delivery across Adult Services, ensuring high-quality patient care, compliance with regulatory requirements and efficient operations. Ensures compliance with patient care quality standards and oversees the planning, organization and direction of the overall nursing and direct patient care services. 

The CNO reports to the system Chief Nurse Executive and has a matrix reporting structure with accountability of operational performance to the President of Adult Services. The CNO collaborates with the Associate Chief Medical Officer and President of Adult Services to implement and evaluate the outcomes of strategic initiatives to improve quality, safety, efficiency and engagement that support overall financial resiliency of the enterprise. The triad leadership team partners closely with our academic partner to ensure alignment of services and clinical care delivery across the continuum of their respective services.

As a member of the Nurse Executive Team, this role supports standardization and evaluation of clinical operations to establish desired nursing outcomes relevant to professional nursing practice system-wide. As a member of the Adult Services leadership team, the CNO is expected to demonstrate transparency, integrity and consistency in all interactions and to work collaboratively with peers, supporting them as well as holding them accountable as members of the leadership team.

Essential Responsibilities:

Communication and Relationship Building

Effective Communication — Demonstrate skill in interpersonal communication.

• Communicate in a way as to maintain credibility and relationships.

• Make oral presentations and produce written materials to diverse audiences.

• Create a shared vision.

• Assert views in non-threatening, non-judgmental ways.

Relationship Management — Create a trusting environment by following through on promises and concerns, establishing mechanisms to follow-up on commitments and balancing the concerns of individuals with Adult Services and enterprise goals and objectives.

• Engage staff and others in decision-making, promote decisions that are patient centered.

• Facilitate consensus building to achieve outcomes through engagement of stakeholders.

• Inspire desired behaviors and manage undesired behaviors by addressing and modeling appropriate conflict resolution.

Diversity — Establish an environment that values diversity (e.g. age, gender, race, religion, ethnicity, sexual orientation, culture).

• Establish cultural competency in the workforce.

• Incorporate cultural beliefs into care delivery.

• Provide an environment conducive to opinion sharing, exploration of ideas and achievement of outcomes.

Community Involvement — Represent the organization to non-health care constituents within the community, serving as a resource to community and business leaders regarding nursing and health care.

• Represent the community perspective in the decision-making process.

• Serve on community-based boards, advisory groups and task forces.

Medical and Staff Relationships — Build credibility with physicians as a champion for patient care, quality and the professional practice of nursing. Create opportunities for physicians and nurses to engage in professional dialogue.

• Collaborate with medical staff leaders and other disciplines in determining needed patient care services, equipment, facility needs, developing patient care protocols, policies and procedures.

• Confront and address inappropriate or disruptive behavior towards patients and staff using medical staff bylaws to address physician performance issues.

• Represent nursing at medical executive committee and other department and medical staff committees.

Academic Relationships — Accountable for maintaining and promoting positive academic relationships within the organization, in support of system-wide strategies relative to nursing workforce, education and development.

• Determine current and future supply and demand for nurses to meet the care delivery needs.

• Identify educational needs of nursing staff.

• Collaborate with appropriate nursing programs in evaluating quality of graduating clinicians and developing mechanisms to enhance this quality, and by serving on academic advisory councils.

• Collaborate in nursing research translating evidence into practice, and in investigating care delivery models across the continuum.

Business Skills

Financial Management — Develop and manage an annual operating budget, interpret financial statements and manage financial resources.

• Use business models for health care organizations and apply fundamental concepts of economics.

• Ensure the use of accurate service charging mechanisms.

• Educate patient care team members on financial implications of patient care decisions.

• Participate in contract compliance (e.g., physicians, service providers).

Human Resources Management — Participate in workforce planning and employment decisions, analyze supply and demand market data, contribute to the development of compensation, recruitment, onboarding, retention, reward and recognition strategies.

• Ensure development and implementation of an outcome-based performance management program.

• Ensure development of educational programs to foster workforce competencies, development goals and re-educate the workforce for future new roles.

• Evaluate the results of employee engagement and quality of work environment surveys.

• Formulate programs to enhance work-life balance and healthful work environments, and to address sexual harassment, workplace violence and verbal and physical abuse.

Strategic Management — Create the operational objectives, goals and specific strategies required to achieve specific strategic outcomes in Adult Services.

• Promote system mission, vision and values for nursing, leading that process and encouraging active engagement.

• Participate in Adult Services strategy development, conduct SWOT and Gap analyses, engaging staff members and ensuring communication of broad strategy.

• Ensure Nursing operational plan to support Adult Services strategic initiatives and outlook.

• Utilize the key performance indicators for analysis to manage change, evaluate achievement of operational objectives and goals.

Information Management & Technology — Promote technology in supporting improvement of clinical and financial performance, use data management systems for decision-making and provide leadership for the adoption and implementation of information systems.

• Collaborate in prioritization of information technology resources and participate in evaluation of enabling technology in practice settings.

• Identify technological trends, issues and new developments as they apply to patient care.

Knowledge of the Health Care Environment

Clinical Practice Knowledge — Demonstrate knowledge of current nursing practice and the roles and functions of patient care team members ensuring compliance with the State Nurse Practice Act, State Board of Nursing regulations, state and federal regulatory agency standards, federal labor standards and policies of the organization.

• Communicate patient care standards as established by accreditation, regulatory and quality agencies and adhere to professional association standards of nursing care and professional practice.

• Ensure that clinical policies and procedures are reviewed and updated in accordance with evidence-based practice.

• Ensure protection of human subject rights and safety in clinical research.

Delivery Models & Work Design — Assess the effectiveness of delivery models, develop new patient care delivery models across the continuum and participate in the design of facilities.

• Utilize various delivery systems and age-appropriate patient care models and the advantages and disadvantages of each.

• Align care delivery models and staff performance with key safety and economic drivers (e.g., value-based purchasing, bundled payment).

• Take appropriate action when opportunities exist to respond effectively to environmental changes.

Health Care Economics & Policy — Understand regulation and payment issues that affect finances and use knowledge of federal and state laws and regulations that affect the provision of patient care (e.g., tort reform, malpractice, negligence, reimbursement).

• Ensure an understanding of Adult Services payer mix, CMI and benchmark database.

• Participate in legislative process on health care issues through such mechanisms as membership in professional organization and personal contact with officials.

• Educate patient care team members on the legislative process, the regulatory process and methods for influencing both.

• Interpret impact of legislation at the state and federal level on nursing practice.

Evidence-Based Practice, Outcome Measurement & Research — Use data and other sources of evidence to inform decision making and to establish standards, practices and patient care models in alignment with system-wide nursing colleagues.

• Design feedback mechanisms by which to adapt practice based upon outcomes from current processes.

• Design and interpret outcome measures.

• Disseminate research findings to patient care team members.

• Allocate nursing resources based on measurement of patient acuity and care needed.

• Monitor and address nurse sensitive outcomes and satisfaction indicators.

Patient Safety — Support enterprise-wide patient safety program using knowledge of patient safety in partnership with the office of the Chief Quality and Patient Safety.

• Monitor clinical activities to identify both expected and unexpected risks.

• Support a Just Culture (non-punitive) reporting environment, supporting a system for identifying unsafe practices.

• Facilitate and as needed, lead performance improvement teams to improve systems and processes that enhance patient safety.

Performance Improvement & Metrics — Articulate Adult Service performance improvement program and goals using evidence-based metrics to align patient outcomes with the system’s goals and objectives.

• Apply high reliability concepts for the organization.

• Establish quality metrics by identifying the problem and/or process.

• Measure success at improving specific areas of patient care.

• Analyze the root causes or variation from quality standards.

Risk Management — Identify areas of risk and liability, develop systems that result in prompt reporting of potential liability by staff at all levels.

• Facilitate staff education on risk management and compliance issues.

• Identify early-warning predictability indicators for errors.

• Correct areas of potential liability.

• Ensure compliance by staff with all required standards.

Leadership

Foundational Thinking Skills — Apply critical analysis concerns after a review of the evidence to explore new knowledge and ideas.

• Recognize one’s own method of decision making and the role of beliefs, values and inferences.

• Systems Thinking—Provide visionary thinking on issues that impact the healthcare services.

• Use knowledge of classic and contemporary systems thinking in problem solving and decision making.

• Promote systems thinking as an expectation of leaders and staff.

• Consider the impact of nursing decisions on the adult services and health system.

Succession Planning — Drive leader development within across Adult Services, identifying opportunities and promoting growth and development of leaders at all levels.

• Develop a leadership succession plan, establishing mechanisms that provide for early identification and mentoring of staff with leadership potential.

• Promote nursing leadership as a desirable specialty.

• Mentor current and future nurse leaders.

Change Management — As a change leader, use change theory to implement change.

• Adapt leadership style to situational needs.

Professionalism

Personal & Professional Accountability — Hold self and others accountable for mutual professional expectations and outcomes.

• Participate in and contribute to professional organizations and contribute to the advancement of the profession.

• Encourage leader and staff participation in professional organizations, lifelong learning and educational achievement.

• Role model standards of professional practice (clinical, educational and leadership) for colleagues and constituents.

Ethics — Hold self and staff accountable to comply with ethical standards of practice.

• Uphold ethical principles and corporate compliance standards.

• Discuss, resolve and learn from ethical dilemmas.

Career Planning — Develop a personal and professional career plan and measure progress.

• Coach others in developing their own career plans.

• Seek input and mentorship from others in career planning and development.

• Solicit and act on feedback about personal strengths and weaknesses.