Transitioning to an Executive Position


How would you recommend professionally preparing and transitioning from a Nursing Informatics Director position to a VP of Informatics position or Nurse Executive position?

Answers from Charles Boicey:

Transitioning from a Nursing Informatics Director role to VP of Informatics or another Nurse Executive role is primarily a transition from an operational focus to a strategic focus. Although there are strategic components to the Director role, and tactical components to the VP role, the Director’s primary focus is more tactical and focused on driving operational success, whereas the VP role is more focused on defining the strategic vision that will define the operational timeline. While leading large projects as a Director provides important management experience upon which to build a transition to a VP position, that experience alone is insufficient for success at the executive level. Nursing informatics leaders must lead by establishing the strategy and plan for their respective organizations, resulting in technology and informatics that become a natural interwoven component of care delivery and workflow.

AONE suggests that Nursing Informatics Executive leadership roles are best served by individuals with a Master's degree and recognize an upward trend toward doctorate education. There are many options for furthering your education even while still working, including both online and brick-and-mortar institutions that range from introductory certificate programs through Masters and Doctoral level with an emphasis on Nursing Informatics.

Next consider finding a mentor or engaging a Coach. Coaching is effective because it can be tailored to an individual’s needs. Through coaching one can focus on changing behavior to become effective in the new role. Coaching facilitates the adaptation to a new culture, a more complex job, new professional relationships and helps to strengthen leadership behaviors. For instance, a Coach would be very helpful in providing feedback, such as videotaping of mock interviews, regarding effective communication with C-suite and other executive-level leaders.

Mentoring focuses on the development of new skills and is a personal relationship with an individual who has experienced success in the field of interest. In this case, a nurse who has successfully transitioned to the executive level would provide invaluable insight into their own experiences of what worked well or didn’t quite work as expected. A mentor would also be able to provide ongoing real-time advice as you design and begin to traverse your strategic transition.

It is essential that as you transition from one role to another in Nursing Informatics that you never lose touch with your colleagues on the front lines and the patients they serve. Remember to take some time to visit your organizations nursing units and clinics. You will be surprised at how much change is taking place and your strategic plans will be grounded in reality.

Answers from Karen Carroll:

In 2011 AONE's technology committee began the work to develop the AONE position Paper on the Nursing Executive Leader. I was one of the group leaders who developed this paper. The nurse executive role benefits health care institutions and the nursing discipline to propel the organic nature of technology and innovation forward.

This position paper comes at a strategic time; working in a hospital setting nurses may hear comments referring to technology as "the change adds extra clicks and work to my practice and it removes me from the patient". Words like these express common concerns regarding the electronic medical records (EMR) implementation and post implementation improvements. Rather than innovation serving to improve the care delivery system, these statements illustrate that staff sometimes justly perceive technology as little more than a drain. For those professionals considering a move to the executive level nurse informatics role it is important to understand the strategic nature and benefit of a nurse executive to work with other members and have such statements become "never events". Finally, Meaningful Use rules knowledge enhances the ability for a CNIO to advise the organization related to creating a technical roadmap that ensures successful compliance with regulatory requirements. 
Some sample of knowledge skills/understanding of a CNIO include: solid nursing clinical experience and expertise, workflow redesign knowledge, project management, clinician training and instituting supporting structures and processes.

Other important attributes/thoughts

  1. At the C-suite level there is a need to assist an organization in understanding, developing, and then communicating the details of an organizations innovation strategic plan to all levels of the organization.
  2. One of the best outcomes of understanding an organizational mission and is to learn about an organization’s success factors. A CNIO at the c-suite level is uniquely positioned to assist organizations with their technology and innovation projects and implementations.
  3. Become an expert in an aspect of innovation and how it affects practice. There are many opportunities at professional organizations and one’s hospital. Keep a journal and write down the learning that has occurred in either the workplace or the professional arena. The literature is begging for rigorous descriptions of what has worked, what you have learned, and what next steps to take.
  4. Consider collecting data on pre and post implementations. The field is begging for rigorous research on the impact to patients and staffing.

Concluding thoughts:

The overall benefit is that the CNIO is able to establish systems in place which link new innovations and impact to outcomes and reporting. Performance measurement of clinical outcomes along with financial impacts, patient safety, and operational efficiency are part of comprehensive measures to be mutually agreed upon by the CNIO, CNO, and other C-suite members.

  • AONE Position Paper (2012) Nursing Informatics Executive Leader
  • HIMSS Position Statement (2011) Transforming Nursing Practice through Technology & Informatics

April 2012