The development of leadership outcome‐indicators evaluating the contribution of clinical specialists and advanced practitioners to health care: a secondary analysis

Abstract

Aims To report a secondary analysis of data collected from the case study phase of a national study of advanced practitioners and to develop leadership outcome‐indicators appropriate for advanced practitioners. Background In many countries, advanced practitioners in nursing and midwifery have responsibility as leaders for health care development, but without having leadership outcome measures available they are unable to demonstrate the results of their activities. In Ireland, a sequential mixed method research study was used to develop a validated tool for the evaluation of clinical specialists and advanced practitioners. Despite strong evidence of leadership activities, few leadership‐specific outcomes were generated from the primary analysis. Design Secondary analysis of a multiple case study data set. Methods Data set comprised 23 case studies of advanced practitioner/clinical specialists from 13 sites across each region in Ireland from all divisions of the Nursing Board Register. Data were collected 2008–2010. Data sources included non‐participant observation (n = 92 hours) of advanced practitioners in practice, interviews with clinicians (n = 21), patients (n = 20) and directors of nursing/midwifery (n = 13) and documents. Analysis focused on leadership outcome‐indicator development in line with the National Health Service's Good Indicators Guide. Results The four categories of leadership outcomes for advanced practitioner developed were as follows: (i) capacity and capability building of multidisciplinary team; (ii) measure of esteem; (iii) new initiatives for clinical practice and healthcare delivery; and (iv) clinical practice based on evidence. Conclusions The proposed set of leadership outcome‐indicators derived from a secondary analysis captures the complexity of leadership in practice. They add to existing clinical outcomes measuring advanced practice.

Describing the leadership capabilities of advanced practice nurses using a qualitative descriptive study

“…An exception is a large case study, conducted in 13 sites across Ireland and involving 23 Clinical Nurse Specialists and Advanced Practitioners (Clinical Midwife Specialists and Advanced Nurse Practitioners). An important finding of this study was the identification of multiple activities that focused on two areas of leadership; clinical and professional (Begley et al., ; Elliot, Begley, Kleinpell, & Higgins, ; Elliot et al., ). Clinical leadership activities supported the development of nursing practice in clinical settings or services.…”

“…Clinical leadership activities supported the development of nursing practice in clinical settings or services. Professional leadership activities supported the development of nursing practice outside the service at the national or international level (Elliot et al., , p. 1039).…”

An inductive qualitative approach to explore Nurse Practitioners views on leadership and research: An international perspective

“…Although research is part of the regulatory requirement for NPs in both Ireland and Australia, little research is available on this aspect of the role. The leadership role has been researched in Ireland, but no research has been found pertaining to leadership in Australian NPs (Elliott et al, , , ). There is no research to date comparing NPs leadership activities across two countries, or indeed ascertaining if NPs identify themselves as leaders of the nursing profession.…”

Commitment to patient-centred experiences at both the organisation and clinician level optimises empowerment of hospitalised older adults with advanced disease

“…Organisations must explore innovative models of care that enhance care continuity. Advanced practice nurse roles have clearly demonstrated enriched staff knowledge and enhanced attitudes and tone of care 5. Furthermore, Acorn6 reported enhanced care continuity and satisfaction with an autonomous nurse practitioner as most responsible provider model for seniors admitted to a community hospital.…”