President’s Column: Embracing Dramatic Innovation

Jan 02, 2019

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I believe that nursing is a key leader in building a healthcare system driven by the needs of patients and their families.

There are multiple studies that outline the relationship of nurse staffing to improved outcomes, increased patient satisfaction and reduction of hospital-acquired conditions. Yet, you emphatically told us during a recent series of focus groups and surveys that appropriate staffing was the biggest obstacle you face to provide care the way you wish to provide it.

The concept of appropriate staffing is not new to the AACN community. We made a bold statement over a decade ago — in 2005 — proclaiming that appropriate staffing was one of six key standards of a healthy work environment.

We define appropriate staffing as, "Where the needs of the patient are matched with the competency of the nurse, with staffing policies in place that are solidly grounded in ethical principles and support the professional obligation of nurses to provide high-quality care." And last year at NTI 2018 in Boston, our president, Chris Schulman, announced that we were reaffirming the importance of appropriate staffing and intensifying our commitment.

So, we asked to hear about the innovative solutions that you and your colleagues have put into place to achieve appropriate staffing. Many of you have already answered the call to share. One example we learned about is the Care Zones model, which was established at Emory University Hospital in Atlanta. This unique model features:

  • Grouping patients according to acuity
  • Matching nurses' skills with patients' needs
  • Zoning nurses closer to their assigned patients
  • Pairing two nurses per zone in a "buddy system"

The Care Zones model of staffing was implemented to improve patient outcomes and increase nurse satisfaction. Before its implementation, nurses were walking at least 6 miles per shift because of the large unit layout and the staffing model in place. Nursing leadership and staff both agreed, and worked together to create a system so that they now work smarter and more efficiently. If you haven't already, please read more or submit your own staffing solution at

I'm also excited to share that AACN convened leaders from other nursing and healthcare associations in early October 2018. We spent a focused and exciting day of possibilities with influential healthcare leaders, who all agreed it is time to shift the conversation from nursing as a hospital expense to nursing as an investment.

Our AACN community and our partners are committed to using our collective voice and strength to address the complexities of appropriate staffing. We all want to find a better model for staffing, so nurses can make their optimal contributions. Of course, addressing this complex issue will take time — but rest assured that we are committed to investing the time and resources needed to continue this crucial work.

How are you using your voice to improve staffing in your healthcare facility? I would love to hear your innovative ideas. Write to me at