OO - Organizational Overview

OO5: The administrative and nursing organizational chart(s). Describe the CNO’s structural and operational relationships to all areas in which nursing is practiced. (TL4)

The Chief Nursing Officer (CNO), Rita Smith, reports directly to the Chief Executive Officer. The Organizational Chart has the CNO presiding over the entire Patient Care Services, both inpatient and outpatient. Her departments include: medical surgical areas, observation unit, pediatrics, mother/child health (labor and delivery, post-partum and newborn nursery), maternal/fetal medicine, newborn intensive care unit, perioperative services (operating room, post-anesthesia care room, pre-admission testing, same-day-services, endoscopy), interventional/cardiac catheterization laboratory/electro-physiology, infection control, nursing administration, nursing education, employee health, critical care (intensive care unit, cardiac care unit and cardiac step-down unit), emergency department, emergency medical services, behavioral health, ambulatory services and renal dialysis. There are three nursing Director positions. These positions report directly to the CNO and they are: Director of Perioperative Services, Mother/Child Health, Newborn Intensive Care, Cardiac Catheterization Laboratory and Interventional Radiology. The second Director position oversees The Nursing Education Department and Stroke. The third Director position oversees the Emergency Department, Medical/Surgical Units and the Critical Care Division. The CNO mentors and provides leadership to the Clinical Directors who oversee their units administratively and clinically. The Directors meet individually with the CNO on a weekly basis to discuss issues and concerns relational to their respective units. During these meetings strategies are developed to address future initiatives and goals. Most of the units have a Nurse Manager who presides over the day to day issues of the units. Nurse Managers often meet weekly with their Directors as a group in order to communicate problems and issues.

The CNO meets on a monthly basis with the Leadership Team (Nurse Managers and Directors) in order to establish a direct line of communication with them. This meeting is frequently used as a conduit for introducing new systems or ideas into the hospital. The CNO gives a Senior Vice Presidents report, providing a financial and strategic overview resulting from senior leadership discussions. Pertinent information from the Executive Leadership team is disseminated. This meeting also provides a forum for the Nurse Managers to give feedback from their individual units and share information with each other. The CNO provides feedback from the individual councils to insure that the managers are updated on all pertinent clinical information and new initiatives. Problems that the nurse managers may have with the various systems or processes hospital-wide are frequently discussed in this forum. Management from other services is invited to speak and/or answer questions on these issues. Nurse Managers may be requested to provide educational presentations at these meetings, particularly to report on new initiatives or quality improvements on their units.

Many of the larger more complex units have Charge Nurses who report to their individual Nurse Managers. The role of the Charge Nurse is frequently to prepare patient assignments, attend rounds with physicians and other interdisciplinary team members and insure the unit is operating smoothly. The Charge Nurses in the Critical Care Division attend Rapid Response Calls and Code Blue calls throughout the hospital. The Charge Nurse frequently functions as the clinical resource person on the unit sharing knowledge with their peers. The Charge Nurse group can access the CNO, either through a staff meeting that she may attend or during one of the Town Hall meetings where everyone is encouraged to participate.

The CNO meets monthly with the Chairpersons of all the individual councils. The Councils include: Nurse Practice, Retention and Satisfaction, Research, Performance Improvement, Advanced Practice Nurses, Leadership, Quality and Safety, Executive and the Unit Practice Councils. The Chairpersons of these councils keep the CNO apprised of councilor attendance and functioning. They frequently share ideas with the CNO and with each other. The CNO is able to keep informed of issues pertaining to the staff nurses. The CNO mentors this group as well and discusses future plans with them.

The CNO has quarterly Town Hall meetings with the nursing staff. She will go directly to their units so that the maximum number of people can attend. She presents an agenda of issues to be discussed that are of concern to staff nurses and encourages open discussion. During this meeting, the nursing staff is encouraged to ask questions or present issues which directly impact on them and their units. She announces new initiatives and discusses the goals/plans of the organization at this meeting. Occasionally the Chief Executive Officer attends this meeting to answer questions or address concerns the nursing staff may have.

On occasion, the CNO will attend a unit staff meeting. At times this is necessary if an administrative decision impacts more on one particular unit than another. She is more than willing to discuss issues at the unit level if necessary and address concerns that the staff may have.

The Chief Nursing Officer oversees the Employee Health Nurse team which includes an Advanced Practice Nurse and provides input into their areas. She meets with them individually and they participate in all the nursing committees and activities. She assists these areas in the development of policies and program development. She promotes the flu vaccination program on behalf of the employee health nurses and ensures that this is an organizational priority. She has supported efforts to expand occupational health in the community, particularly on the Jersey City waterfront. She supports the distribution of the influenza vaccine in the community. The employee health nurses biannually perform blood pressure screenings, glucose monitoring and distribute flu shots to the corporate community located on the waterfront. During Heart Healthy week, the employee health department visited the office of the Jersey City Mayor (Mayor Healy) and performed blood pressure screenings on his staff. They have also visited a local high school and performed blood pressure checks on the students and teachers. During the annual Wellness Fair, the employee health nurses screen for prostate cancer by collecting blood samples for PSA levels. Information on prostate cancer is distributed to employees. They further collect blood to perform a lipid panel on employees in order to check for cholesterol levels.

The CNO reviews the infection rates with the infection control nurses and consults with them on all questions pertaining to infection control issues.

Department of Nursing Organizational Chart (Appendix 005-A)

Administrative Organizational Chart (Appendix 005-B)