Healthcare reform has taken an already demanding and complex nurse executive role and created an environment where chief nursing officers (CNO's) must “up their game.” Prior to joining McKesson, Catherine Whelchel, senior product manager and clinical strategist with McKesson Capacity Management, was the CNO for a southern regional medical center where she experienced first-hand the dedication and drive of nursing teams to improve care and quality standards. But that isn't enough today. Technology plays a vital role, which she discussed during her recent participation in a panel discussion, “Healthcare Reform and Revamping the Role of the CNO,” at the annual meeting for Becker's Hospital Review. Below is an overview of her insights.

The Evolving Role of Nurse ExecutivesWhat is the single most significant way the CNO job has changed since the ACA was signed into law?

Whelchel: More than ever, the CNO is knee deep in financial management; however, to meet the reporting requirements of ACA, nurse executives must incorporate even more data analysis where we're looking at sustaining margins, cost-benefits and supply and demand. It's elevating our relationships with other C-suite partners. Nurse executives must also expand their perspective from an acute-care focus to a population health focus, which requires enhancing patient engagement and education.

What skills are CNO's finding they need to refine - or maybe even develop - as their role evolves under the ACA?

Whelchel: Back in 2009, the HiTech Act drove the adoption of EMRs across the industry. Today, the role of the CNO goes beyond EMRs. It is now about getting the right meaningful data to the right role and that includes accurate budgeting and forecasting to manage capacity for today's supply and demand. Nurse executives must understand what is happening across the board in all service lines and be skilled at collaboration as they navigate a matrix model.

By design, hospitals are now caring for sicker, higher acuity patients. How is this impacting the CNO role?

Whelchel: Higher acuity equals higher resources all the way around. The CNO needs an organizational perspective to make sure all systems are optimized and that includes tools for real-time data for frontline staff and accurate demand forecasting to support systems and management to get the right skill sets at the right time and the right place.

Nurses on the floor, by design of the ACA, play a more central and more important role in patient care than ever before. How does that roll up to the CNO?

Whelchel: The staff mix is changing as we look for more nurses with a bachelor of science and for more support staff. The CNO has to be creative in strategic partnerships with nursing schools, with marketing and talent teams, etc. for the best opportunities at recruitment and retention goals.

What further change do you see on the horizon?

Whelchel: We'll find alternative models of care to better support patient education and care across the continuum, to better support the patient at home and to lower the cost of care. This should include less invasive procedures and more same-day surgeries. We're also going to see more technology with sophisticated wearables and mobile devices becoming more integrated into care to increase patient engagement in wellness. With boundary lines across the continuum blurring, we'll see the use of predictive forecasting, planning and adjusting ahead and in the moment to match demand to staffing.

Related: Learn about McKesson's Capacity and Workforce Management Solutions

This post originally published on May 20, 2016 as The CNO Role in Healthcare Reform: How to Improve Your Game on McKesson's Focus Ahead for Better Health Blog.

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