Transformation to an excellent nursing organization: A chief nursing officer's vision and experience

Abstract

This chapter takes a pragmatic approach, inspired by current evidence and scientific insights, to the journey of nursing services in health-care organizations aspiring to excellence. Here, excellence is used as in Jim Collins' definition of a good company in his book Good to Great: "Good is not good enough." The focus is on sustainability of the results obtained, supported by leadership and the organizational culture. Excellence seems to be a problem or challenge rather than a status or reality. It is indeed important to build organizations that are able to continuously improve their results. However, health care involves people-intensive organizations, which means that results depend on the actions or behavior of people rather than on making the right machine settings. People are the determinants of variations in care. Consequently, it is important for an organization whose goal is to maintain and improve health, that is, any hospital, to have its own approach for achieving excellence. With this in mind, guided by principles of leadership and good governance, excellence will be discussed in terms of four components: strategy and leadership, structure, process, and outcome.