Essential II: Organizational Systems and Leadership.
Recognizes that organizational and systems leadership are critical to the promotion of high quality and safe patient care. Leadership skills are
needed that emphasize ethical and critical decision making, effective working relationships, and a systems-perspective.
As you plan, develop, implement and evaluate your nursing practicum project, reflect on how this project and your graduate education have prepared you to meet the growing needs of healthcare and the diverse populations we serve.
Organizational and systems leadership are critical to the promotion of high quality and
safe patient care. Leadership skills are needed that emphasize ethical and critical decision
making. The master’s-prepared nurse’s knowledge and skills in these areas are consistent
with nursing and healthcare goals to eliminate health disparities and to promote
excellence in practice. Master’s-level practice includes direct care and a
focus on the systems that provide care and serve the needs of a panel of patients, a
defined population, or community.
To be effective, graduates must demonstrate leadership by initiating and
maintaining effective working relationships using mutually respectful communication
and collaboration within interprofessional teams, demonstrating skills in care
coordination, delegation, and initiating conflict resolution strategies. The master’s prepared
nurse provides and coordinates comprehensive care for patients–individuals,
families, groups, and communities–in multiple and varied settings. Using information
from numerous sources, these nurses navigate the patient through the healthcare system
and assume accountability for quality outcomes. Skills essential to leadership include
communication, collaboration, negotiation, delegation, and coordination.
Master’s-prepared nurses are members and leaders of healthcare teams that deliver a
variety of services. These graduates bring a unique blend of knowledge, judgment, skills,
and caring to the team. As a leader and partner with other health professionals, these
nurses seek collaboration and consultation with other providers as necessary in the
design, coordination, and evaluation of patient care outcomes.
In an environment with ongoing changes in the organization and financing of health care,
all master’s-prepared nurses must have a keen understanding of healthcare
policy, organization, and financing. This content aims to prepare a graduate
to provide quality, cost-effective care, participate in the implementation of care, and assume a leadership role in managing human, fiscal, and physical healthcare
resources. Program graduates understand the economies of care, business principles, and
how to work within and affect change in systems.
The master’s-prepared nurse must analyze the impact of systems on patient outcomes, including analyzing error rates. These nurses will be prepared with knowledge
and expertise in assessing organizations, identifying systems’ issues, and facilitating
organization-wide changes in practice delivery. Master’s-prepared nurses must use effective interdisciplinary communication skills to work across departments
to identify opportunities and design and test systems and programs to improve
care. In addition, nurse practice at this level requires an understanding of complexity
theory and systems thinking and the business and financial acumen needed for the
analysis of practice quality and costs.
• Leadership, including theory, leadership styles, contemporary approaches, and
strategies (organizing, managing, delegating, supervising, collaborating, coordinating)
• Data-driven decision-making based on an ethical framework to promote culturally
responsive, quality patient care in a variety of settings, including creative and imaginative
strategies in problem-solving
• Communication–both interpersonal and organizational–including elements and
channels, models, and barriers
• Conflict, including conflict resolution, mediation, negotiation, and managing conflict
• Change theory and social change theories
• Systems theory and complexity science
• Healthcare systems and organizational relationships (e.g., finance, organizational
structure, and delivery of care, including mission/vision/philosophy and values)
• Healthcare finance, including budgeting, cost/benefit analysis, variance analysis, and
• Operations research (e.g., queuing theory, supply chain management, and systems
designs in health care)
• Teams and teamwork, including team leadership, building effective teams, and