161chapter SIX
The Role of the Clinical Executive
Barbara Wadsworth , Tukea L. Talbert , and Robin Donohoe Dennison
■ SUPPLY, DEMAND, AND PREPARATION OF A CLINICAL
EXECUTIVE— WHY IS IT IMPORTANT?
Over the past decade, there has been emerging evidence of the connection between orga-
nizational performance and leadership (Frearson, 2002; Hallinger & Heck, 1996; Muijs,
Harris, Lumby, Morrison, & Sood, 2006). The Institute of Medicine (IOM) Committee
on the Quality of Health Care in America has issued a mandate to the American health
care community to bring “state- of- the- art” health care to all Americans (Fasoli, 2010,
p. 25). Fasoli indicates that nursing has reached a point of inflection, a tipping point, and
the nursing role must evolve in order to remain fully engaged in health care. Of even
greater importance, the nurse leader must be prepared to change and create health care
policies, create and implement evidence- based practice guidelines, and embrace and
represent quality nursing practice at every level of the organization and of society. Now
is the time to ensure that the right people are in key leadership positions, and that those
individuals are well prepared to face the dynamic environment and challenges of the
health care milieu. Organizational performance during this turbulent time in health care
will be contingent on the effectiveness of the leadership team.
The American Association of Colleges of Nursing (AACN) in its position statement
(2004) puts forth that the transformation in the health care delivery system will require
clinicians to design, evaluate, and constantly improve the context in which care is deliv-
ered. The AACN strongly believes that nurses with doctoral preparation that encom-
passes clinical, organizational, economic, and leadership skills are most likely capable
of critiquing scientific findings and subsequently developing programs of care that sig-
nificantly impact health care and that are economically feasible. The AACN adopted the
Doctor of Nursing Practice ( DNP) position statement in October 2004 calling for a trans-
formational change in the education necessary for professional nurses who will practice
at an advanced level of nursing practice, The Essentials of Doctoral Education for Advanced
Nursing Practice (AACN , 2006). The AACN recognizes the practice demands affili-
ated with an increasingly complex health care system amid a major health care reform
that has gotten new momentum from the President Obama administration. One can