560 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
balancing a high commitment to the institution (Eisenstat, Beer, Foote, Fredberg, &
Norrgren, 2008). These requisite leadership skills, coupled with the knowledge to influ-
ence health care outcomes, afford doctoral- level clinical executives an opportunity to
effect change like no other time in nursing’s history.
At the end of the day, it is all about leadership. The clinical executive of tomorrow,
with a doctoral advanced nursing practice education, plays a pivotal role in supporting
an autonomous and professional nursing practice culture. Successful implementation
of an empowered environment rests with the nurse leader’s ability to create a construc-
tive atmosphere, which involves the implementation of supportive infrastructures that
encompass accountability, pursuit of excellence, and open communication. In this way,
clinical nurses are allowed the autonomy to make decisions and foster practices in
accordance with professional nursing standards. Thus, a progressive nurse leader can
shape an institution through one’s value system and passion for nursing. With this
model, innovative care models will develop and flourish (Upenieks, 2003).
High- performing organizations and/ or those organizations that aspire to become
high- performing organizations will closely scrutinize leadership capacity (Wells &
Hejna, 2009). Hospitals and health care institutions will be among them. Magnet hospi-
tals, designated facilities that have been certified by the American Nurses Credentialing
Center (ANCC) for their excellence in nursing practice, will continue to be recognized
as institutions with superior measures of nursing job satisfaction and patient outcomes
because of their distinguished organizational characteristics. These institutions will
maintain well- qualified nurse executives in an organizational structure that empha-
sizes open participatory management and will use professional practice models for
the delivery of nursing care. Strong leadership and advocacy for nursing offers an
autonomous, self- managed, self- governed climate that allows nurses to fully prac-
tice their clinical expertise. Additionally, the burgeoning Planetree Model of Care^5 is
an important new player in hospital/ health care network certification, or recognition
wave mostly started by the Magnet® Corporation. Planetree was founded by a patient,
Angelica Thieriot, in the 1970s who had a bad experience while being hospitalized
(Rovner, 2012). The Planetree Model focuses on patient- centered care that is built on
the cultural transformation of an institution, patient activation, staff engagement, lead-
ership development, performance improvement, and design services that support
adaptive, healing environments, wellness, and enhancing the safety and nurturing
of patients. Magnet, Planetree, and Nurses Improving Care for Healthsystem Elders
(NCHE) recognized health care facilities as all institutions where executive nursing
leadership is at the core of high- level health care innovation and delivery, and where
advanced education can readily make the difference on both an institutional and sys-
tems level.
As clinical nurse executives acquire doctoral- level knowledge and competencies
in greater numbers and with health care reform expanding every year, nurse leaders
will be asked to participate on hospital boards, lead organizations, and provide con-
sultation on various practice models and initiatives. The doctoral- level nurse executive
will have the requisite knowledge, experience, and competencies to skillfully manage
an array of complex organizational issues. In the future, we will see clinical executives
with doctoral advanced nursing practice education in greater numbers as senior health
care executives such as chief executive officer, chief operating officer, or chair of the
Board of Trustees, as organizations begin to realize their value. As DNP- educated nurse
executives improve health and health care outcomes through evidence- based practice,
utilize knowledge related to evidence- based approaches for quality and safety improve-
ment, and apply research processes to decision making, we will see innovation like
never before.