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AONL

NURSE EXECUTIVE COMPETENCIES

The AONL Nurse Executive Competencies© represent the functional knowledge, skills, abilities and personal characteristics required to produce a set of activities that generate observable and measurable outcomes. The Nurse Executive Competencies© are based on the AONL Nurse Leader Core Competencies©.

In the AONL Nurse Leader Core Competency model©, the anchoring domain, Leader Within, anchors the five core domains: Business Skills and Principles; Communication and Relationship Building; Knowledge of the Health Care Environment; Professionalism; and Leadership. It is the driver of motivation, beliefs, values and interests, and recognizes that the influence and significance of education, experience and understanding oneself is essential.

A circle represents each core domain. The gradient border symbolizes the influence of both the art and science of nursing and the open center informs the role specific functional competencies driven by the core domain. The overlap depicts the interrelatedness of the domains in practice. The Leadership domain’s placement in the center supports and enables this interrelatedness of requisite knowledge, skills and abilities between and among the core domains.

OVERVIEW

AONE, AONL. (2023). AONL Nurse Leader Core Competencies, Chicago, IL: AONE, AONL. Accessed at: www.aonl.org • Accessible at: www.aonl.org/competencies • Contact: [email protected] or (312) 422-2800 © 2023 American Organization of Nurse Executives (AONE), American Organization for Nursing Leadership (AONL). All materials contained in this publication are available to anyone for download on www.aonl.org, for personal, non-commercial use only. No part of this publication may be reproduced and distributed in any form without permission of AONL, except in the case of brief quotations followed by the above suggested citation. To request permission to reproduce this material, please email [email protected].

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Reliability and validity for the AONL Nurse Executive Competencies are established by periodic job analysis/role delineation studies. These competencies are based on the Job Analysis Report: American Organization for Nursing Leadership Certified in Executive Nursing Practice, February, 2023.

REFLECTIVE PRACTICE

• Demonstrates reflective practice and an understanding that all leadership begins from within.

• Solicits feedback from trusted sources about personal strengths and opportunities for improvement, incorporating the information into practice.

• Recognizes the contribution of mental models on behavior.

FOUNDATIONAL THINKING

• Learns from challenges, setbacks and failures as well as successes.

• Recognizes the role of beliefs, values and influences in one’s own method of decision-making.

• Maintains curiosity and an eagerness to explore.

CAREER DEVELOPMENT

• Learns from challenges, setbacks and failures as well as successes.

• Recognizes the role of beliefs, values and influences in one’s own method of decision-making.

• Maintains curiosity and an eagerness to explore.

PERSONAL AND PROFESSIONAL ACCOUNTABILITY

• Participates in life-long learning.

• Maintains competency through nationally recognized certification.

• Participates in professional organizations that advance one’s leadership and career development.

• Prioritizes self-care health behaviors through daily practices and routines; practices healthy work-life integration.

LEADER WITHIN

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PROFESSION ACCOUNTABILITY

• Upholds professional ethical principles in decision-making through personal and organizational accountability.

• Supports, promotes and role models standards of nursing and leadership professional practice (clinical, educational, certification and leadership) for colleagues and constituents.

• Solicits feedback from trusted sources about personal strengths and opportunities for improvement and incorporates the information into practice.

• Maintains competency through nationally recognized leadership certification.

• Participates in professional organizations that advance one’s leadership practice and career development.

• Encourages staff to engage in their career development.

ORGANIZATIONAL ACCOUNTABILITY

• Aligns behavior with personal values and determines fit with the organization’s culture.

• Ensures the voice of the patient is central and present in decision-making.

• Ensures a culture of accountability by holding self and others accountable for measurable high quality and cost-effective outcomes.

• Follows up regularly with staff to ensure that desired outcomes are being achieved.

• Recognizes career opportunities for staff based on strengths and interests.

• Exhibits leadership presence (e.g., attending team meetings, vocal, fostering discussions, lead rounds, etc.).

HEALTH EQUITY AND SOCIAL DETERMINANTS OF HEALTH

• Collaborates on the development of the needs assessment to identify if there are any current health equity issues.

• Creates action plan to see how to close the gap on department/ unit health equity issues.

• Provides staff with tools and resources to provide culturally competent care (e.g., translation resources, discharge materials, appropriate referrals).

• Supports staff in participation of community-based activities that address community care.

• Coordinates and facilities orientation related to culturally competent care.

• Evaluates culturally competent care through performance appraisals.

• Monitors performance data to ensure the delivery of culturally competent care.

GOVERNANCE

• Interacts and educates the organization’s governing body regarding health care and the value of nursing.

• Interacts and educates the organization’s governing body regarding quality and patient safety principles.

• Represents patient care issues to the organization’s governing body.

• Represents nursing in the boardroom and C-suite.

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RELATIONSHIP MANAGEMENT

• Develops relationships across the care continuum to build alliances and partnerships and achieve common goals.

• Manages conflicts and disagreements in a constructive manner.

• Identifies the internal and external relationships that impact the work of the department/unit to achieve department/unit goals.

• Interprets organizational and strategic realities (e.g., labor costs, different models of care delivery, key performance indicators (KPI), supply chain disruption etc.) to navigate changes.

• Recognizes the impact on staff from the organization’s decisions and takes appropriate action.

EFFECTIVE COMMUNICATION

• Communicates with clarity and integrity to build trust with all stakeholders.

• Identifies and understands different communication styles.

• Utilizes appropriate communication style when engaging different audiences.

• Practices transparency and honesty to demonstrate authenticity.

• Builds trust by listening to staff.

INFLUENCING BEHAVIORS

• Collaborate with others to exchange ideas to accomplish goals.

• Uses information from multiple sources (e.g., evidence from research, data, reports) to gain consensus and commitment from stakeholders.

• Coaches staff in their development (e.g., conflict management, active listening, communication, etc.).

• Create policies and initiatives to promote desired organizational behaviors.

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NURSING PRACTICE AND APPLICATION

• Transforms care delivery models and environmental design to ensure the delivery of safe patient care that is evidence-based, accessible, affordable, and equitable.

• Recognizes the impact of internal and external factors on care delivery and the organizational finances.

• Integrates patient quality & safety measures into the care environment.

• Formulates objectives and priorities to implement plans across the continuum of care and practice settings consistent with long-term interests of the organization.

ECONOMICS AND POLICY

• Aligns organizational strategies with current developments in healthcare economics, policy, and legislation.

• Employs a population health approach to improve outcomes.

• Influences health care policy as it affects safe quality, accessible and affordable health care through advocacy at all levels of government.

REGULATION

• Maintains knowledge of regulatory and accreditation standard/rule changes.

• Seeks resources in support of the organization’s compliance regarding regulatory requirements.

• Ensures compliance with accreditation standards and local, state, and federal regulatory standards.

• Participates with response to identified deficiencies.

EVIDENCE BASED PRACTICE

• Ensures a process is in place to evaluate strengths and barriers in implementing evidence-based practices.

• Promotes integration of evidence-based research into practice.

• Supports staff by providing resources for implementation of evidence-based practices.

PATIENT SAFETY AND QUALITY

• Maintains knowledge of patient safety and improvement sciences.

• Ensures the incorporation of patient safety and improvement sciences with organization’s practices.

• Participates in risk assessment (e.g., FMEA, root cause analysis, etc.) to ensure safe, compliant and effective care delivery.

• Develop processes that result in prompt escalation of potential performance gaps by system processes and staff.

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FINANCIAL MANAGEMENT

• Manages budget by understanding and utilizing organization’s financial processes.

• Monitors budget to ensure accuracy of expenses and identify variances.

• Maintains knowledge of reimbursement models that affect care delivery.

• Maintains knowledge of health care economics and business models to set priorities and measurable goals.

• Participates in the creation of department/division budget.

• Makes adjustment of budget as indicated by variances.

• Supports financial health particularly as it is influenced by nursing and other clinical decisions and outcomes.

STRATEGIC MANAGEMENT

• Collaborates with staff in the communication and implementation of high reliability concepts (e.g., safety huddles, use of evidence, deferring to expertise etc) as identified by the organization.

• Utilizes multiple sources of evidence-based data in goal setting and decision-making.

• Ensures organizational objectives are in place to achieve the strategic mission.

• Participates in the negotiation, monitoring and management of contract and service agreements.

• Aligns and creates nursing/clinical objectives, goals and tactics required to achieve the organization’s strategic outcomes.

• Recognizes and supports the benefit and impact of technology on care delivery, clinical information, and financial outcomes.

• Uses evidence-based metrics to align department/unit’s goals and objectives with patient outcomes.

HUMAN RESOURCE MANAGEMENT

• Builds and manages a diverse workforce based on organizational, professional nursing, clinical goals and outcomes, data, budget considerations, and staffing needs.

• Ensures that employees are recruited, selected, onboarded, educated, evaluated, and recognized according to established standards, applicable employment laws, and organization’s mission vision and values.

• Manages a multisector workforce and a variety of work situations.

• Assesses the organization’s culture to ensure the presence of a safe and healthy work environment.

• Addresses any gaps associated with the cultural assessment of safe and healthy work environment.

• Advances organizational policies that allow employees to practice at the top of education and or license.

• Establishes mechanisms that provide for identification and mentoring of staff for career progression.

LEADERSHIPLEADERSHIP

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SYSTEMS AND COMPLEX ADAPTIVE THINKING • Builds a shared vision that articulates and

influences others to translate vision into action.

• Develops new insights into situations by questioning conventional approaches.

• Encourages staff to develop new and innovative ideas.

• Removes barriers to help implement new cutting-edge programs/processes.

• Creates and executes strategies for complex situations (e.g., addressing safety issues with workload capacity, increase nursing time at bed side, selection, and deployment of Artificial Intelligence in nursing).

• Leads nursing strategic planning and execution.

• Participates in nursing and organizational strategy planning and execution.

CHANGE MANAGEMENT • Acts as a catalyst for change by seeking new

information and ideas.

• Adapts to new information, changing conditions and unexpected obstacles.

• Assesses through analytics (e.g., gap analysis, SWOT, etc.) if change is necessary.

• Utilizes common change models (e.g., Kotter, Lewin) and other tools for change (e.g., PDSA, LEAN methods).

• Supports staff in managing organizational changes.

DIVERSITY, BELONGING AND INCLUSION • Recognizes unconscious and systemic bias

occurs in care delivery, business operations, and through external influences.

• Leads and supports initiatives that address racism, discrimination and bias in care delivery and business operations.

• Encourages creative tension and differences of opinions.

• Fosters an inclusive workplace where diversity and individual differences are valued and maximized to achieve the vision and mission of the organization.

• Develops the ability of others to perform and contribute to the achievement of their goals consistent with the organization’s vision and mission corresponding with individual needs.

• Provides feedback and opportunities for others to learn through formal and informal methods corresponding with individual needs.

• Creates, promotes, and protects a culture that supports staff, patients/clients and stakeholders at the organization/system level.

DECISION MAKING • Capitalizes on opportunities and takes

calculated risks.

• Identifies and objectively analyzes problems; evaluates relevance and accuracy of information, generates and evaluates alternative solutions, makes recommendations and decisions.

• Makes timely decisions even when data are limited or solutions produce unpleasant consequences.

• Understands the impact and implications of decisions.

• Delegates appropriately.

• Fosters professional governance in both philosophy and structure.

TRANSFORMATION AND INNOVATION • Actively looks for opportunities and takes

calculated risks to advance organization’s mission and vision.

• Develops an organizational framework to advance innovation.

• Allocate resources for the development of innovation teams or methods.

• Supports the implementation of innovative ideas.