Leadership and Nursing Care Management

Leadership and Nursing Care Management

Fourth Edition

Diane L. Huber, PhD, RN, FAAN, NEA-BC Professor College of Nursing and College of Public Health The University of Iowa Iowa City, Iowa

3251 Riverport Lane Maryland Heights, Missouri 63043

LeadeRsHip and nuRsing CaRe ManageMent isBn: 978-1-4160-5984-4


Copyright © 2010, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc.

All rights reserved. no part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. permissions may be sought directly from elsevier’s Rights department: phone: (+1) 215 239 3804 (us) or (+44) 1865 843830 (uK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com. You may also complete your request on-line via the elsevier website at http://www.elsevier.com/permissions. Leadership and Nursing Care Management


neither the publisher nor the author assumes any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book. it is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient.

the publisher

Library of Congress Cataloging-in-Publication Data Leadership and nursing care management / [edited by] diane L. Huber. – 4th ed. p.; cm. includes bibliographical references and index. isBn 978-1-4160-5984-4 (pbk.: alk. paper) 1. nursing services— administration. 2. Leadership. 3. nurse administrators. i. Huber, diane. [dnLM: 1. nursing services–organization & administration. 2. Leadership. 3. nursing, supervisory. WY 105 L4327 2010] Rt89.H83 2010 362.17’3068–dc22 2009016322

Managing Editor: nancy O’Brien Senior Acquisitions Editor: Kristin geen Associate Developmental Editor: angela perdue Developmental Editor: Jamie Horn Editorial Assistant: Jennifer palada Publishing Services Manager: deborah L. Vogel Senior Project Manager: Jodi M. Willard Book Designer: Charles seibel

printed in united states of america

Last digit is the print number: 9 8 7 6 5 4 3 2 1


Lecia A. Albright, BS, CPHQ, FNAHQ Principal and Owner LARA Consulting, LLC Spotsylvania, Virginia

G. Rumay Alexander, EdD, MSN, BSN Associate Clinical Professor Director, Office of Multicultural Affairs School of Nursing University of North Carolina at Chapel Hill Chapel Hill, North Carolina

Mary K. Anthony, PhD, RN, CS Associate Dean for Research Associate Professor Kent State University Kent, Ohio

Bonnie Weaver Battey, PhD, RN Nursing Education Consultant Antioch, California

Sharon A. Eck Birmingham, DNSc, MA, BSN, RN

Chief Nursing Executive AtStaff, Inc.; Adjunct Faculty University of North Carolina, School of Nursing Durham, North Carolina

Karen W. Budd, PhD, RN Director, Graduate Programs College of Nursing Kent State University Kent, Ohio

Thomas R. Clancy, PhD, MBA, RN Clinical Professor School of Nursing University of Minnesota Minneapolis, Minnesota

Sean P. Clarke, RN, PhD, FAAN RBC Chair in Cardiovascular Nursing Research Lawrence S. Bloomberg Faculty of Nursing,

University of Toronto, and University Health Network

Toronto, Ontario, Canada

Robert W. Cooper, PhD Employers Mutual Distinguished Professor of

Insurance, College of Business and Public Administration

Drake University Des Moines, Iowa

Karen S. Cox, RN, PhD, FAAN Executive Vice President/Co-Chief Operating

Officer The Children’s Mercy Hospital Kansas City, Missouri

Kathleen B. Cox, PhD, RN Assistant Professor University of Virginia School of Nursing Charlottesville, Virginia

Kathy Craig, MS, RN, CCM Craig Research Continuum, LLC Founder and President Davidsonville, Maryland, and Kingston, Leadership and Nursing Care Management

Ontario, Canada


vi Contributors

Laura Cullen, MA, RN, FAAN Evidence-Based Practice Coordinator Research Quality and Outcomes Manager Nursing Services and Patient Care University of Iowa Hospitals and Clinics Iowa City, Iowa

Cindy Jean Dawson, RN, MSN, CORLN Nurse Manager Otolaryngology Head and Neck Surgery Clinic Oral Surgery Clinic University of Iowa Hospitals and Clinics Iowa City, Iowa

Amy London Deutschendorf, MS, RN, APRN, BC Senior Director, Clinical Resource Management The Johns Hopkins Hospital Baltimore, Maryland

Karen N. Drenkard, RN, PhD, CNAA, BC Senior Vice President/Chief Nurse Executive Inova Health System Falls Church, Virginia

Therese A. Fitzpatrick, RN, PhD Clinical Instructor University of Illinois at Chicago, College

of Nursing Chicago, Illinois; Executive Vice President and Healthcare

Practice Leader The Optimé Group Evanston, Illinois

Betsy Frank, RN, PhD, ANEF Professor Indiana State University Terre Haute, Indiana

Maryanne Garon, DNSc, MSN, RN Associate Professor and Graduate Program

Coordinator Department of Nursing California State University Fullerton, California

Gregory O. Ginn, BA, MEd, MBA, PhD, CPA Associate Professor of Health Care Administration Leadership and Nursing Care Management

and Policy University of Nevada Las Vegas, Nevada

L. Jean Henry, PhD Assistant Professor Health Science, Kinesiology, Recreation,

and Dance University of Arkansas Fayetteville, Arkansas

Katherine R. Jones, PhD, RN, FAAN Sarah Cole Hirsh Professor Associate Dean for Evidence-Based Practice Frances Payne Bolton School of Nursing Case Western Reserve University Cleveland, Ohio

Susan R. Lacey, RN, PhD, FAAN Director, Bi-State Nursing Workforce Innovation

Center Director of Nursing Workforce & Systems Analysis Children’s Mercy Hospitals and Clinics Kansas City, Missouri

Jo Manion, PhD, RN, NEA-BC, FAAN Founder and Consultant Manion and Associates Oviedo, Florida

Maureen T. Marthaler, RN, MS Associate Professor Purdue University—Calumet Hammond, Indiana

Amelia Sanchez McCutcheon, RN, PhD Chief Nurse Officer and Executive Lead,

Professional Practice Vancouver Coastal Health Authority Vancouver, British Columbia, Canada



Contributors vii

Matthew D. McHugh, PhD, JD, MPH, CRNP, RN Assistant Professor of Nursing Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing Philadelphia, Pennsylvania

Raquel Meyer, RN, PhD(c) Canadian Institutes of Health Research Doctoral

Fellow Lawrence S. Bloomberg Faculty of Nursing University of Toronto Toronto, Ontario, Canada

Jacqueline Moss, PhD, RN Associate Professor and Assistant Dean for Clinical

Simulation and Technology University of Alabama at Birmingham, School of

Nursing Birmingham, Alabama

Mary Ellen Murray, PhD, RN Associate Dean for Academic Affairs Associate Professor University of Wisconsin—Madison, School of

Nursing Madison, Wisconsin

Lynne S. Nemeth, PhD, RN, MS Associate Professor College of Nursing Medical University of South Carolina Charleston, South Carolina

Heidi Nobiling, RN, MA, MBA, NEA-BC Senior Assistant Director University of Iowa Hospitals and Clinics Iowa City, Iowa


Clinical Nurse Specialist Sharp Mesa Vista Hospital; Core Adjunct Faculty National University San Diego, California

Beth Pickard, BSN President and CEO AtStaff, Inc. Durham, North Carolina

Belinda E. Puetz, PhD, RN Principal, Puetz Consulting Services, Inc.; Editor-in-Chief, Journal for Nurses in Staff

Development Cantonment, Florida

Richard W. Redman, PhD, RN Professor Director, Doctoral and Post-Doctoral Programs University of Michigan School of Nursing Ann Arbor, Michigan

Gene S. Rigotti, RN, MSN, CCNA, BCC Director, Professional Practice Inova Health System Falls Church, Virginia Leadership and Nursing Care Management

Claudia DiSabatino Smith, RN, PhD(c), NE-BC Director, Nursing Research St. Luke’s Episcopal Hospital Houston, Texas

Judith Lloyd Storfjell, PhD, RN, FAAN Associate Professor and Associate Dean Executive Director, Institute for Healthcare

Innovation University of Illinois at Chicago, College of Nursing Chicago, Illinois

Kathleen Williams, RN, BSN, CORLN Assistant Nurse Manager, Department of Nursing University of Iowa Hospitals and Clinics Iowa City, Iowa

Dana Woods, MBA, BA Director of Marketing and Strategy Integration American Association of Critical-Care Nurses Aliso Viejo, California Leadership and Nursing Care Management

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