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Knowledge-based decision making - President's Message - Editorial

AORN Journal, Sept, 2003 by Betty J. Shultz

AORN is a richly diverse and complex organization representing and supporting nearly 40,000 perioperative RNs who work in myriad practice areas and facilities. This fact challenges AORN leaders to make good decisions that provide value to members while also maximizing the use of resources available to AORN. As President of AORN, one of my responsibilities is to work continuously with the Board of Directors to improve our decision-making effectiveness.

Increasing member needs and the resulting demands on AORN resources mean that AORN's leaders need to make decisions based on knowledge about member needs and AORN's limited resources. Although this always is the goal of the Board of Directors, we are taking additional steps to ensure Board members are prepared for their work on the Board, and that they have the tools required to help them make sound decisions for AORN.

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CHALLENGES

AORN has faced numerous challenges successfully during its more than 50-year history, but the challenges facing perioperative nurses and AORN in today's environment are unprecedented. Here are just a few examples of those challenges.

* The practice demands for perioperative nurses are increasing exponentially. Workforce shortages, the advent of new technologies, and regulatory pressures are just a few factors that are increasing the complexity of perioperative practice on a daily basis.

* The competition for members' time and energy is increasing, and they have less time to devote to AORN, chapters, and specialty assemblies. According to a recent AORN staffing survey, 78% of perioperative staff nurses work overtime each week, and nearly 23% have mandatory overtime requirements. (1) In addition, many AORN members have the added responsibility of caring for their children, and a growing number are facing the demands of caring for aging parents. This leaves little time to participate in Association activities.

* Health care facilities have cut back tremendously in their support for staff member education and professional development, which means AORN members must decide how much of their own time and money they can take away from family members and other needs to use for professional development.

* Demands on associations to provide measurable value to their members are increasing. This is especially true for younger members, who may perceive less value in professional affiliations than do members of the Baby Boom generation.

DEALING WITH THE CHALLENGES

In acknowledging these challenges, we have taken several steps to ensure that AORN members receive the highest value from their leaders. First, for the past several years, the President and Executive Director have attended a leadership seminar conducted by the American Society of Association Executives (ASAE) early in the President's term. This seminar, titled "Leading Together," is designed to strengthen the partnership between the chief elected officer (ie, the President) and the chief staff officer (ie, the Executive Director) and to prepare these partners to lead their Association. The seminar also provides information and tools to help shape the functions of the Board of Directors and ensure the Board operates efficiently and effectively. This year, I started a new practice of including the President-elect in this leadership program because he is a key member of the leadership partnership. Including him will help provide leadership continuity beyond a single year.

We then engaged one of the instructors from the ASAE leadership seminar to conduct a program on leadership and effective Board functions for the entire AORN Board of Directors. A key component of this program was a discussion of effective decision-making and the concept of knowledge-based strategic governance, the goals of which are to focus leaders' time and energy on strategic (versus operational) issues facing the perioperative nursing profession and AORN and to ensure all decisions made by the leaders consider what we know to be true about our profession and our Association, rather than what we think we know or what we assume to be true. Decisions must be supported by facts, and an important role of leaders is to be certain those facts are at hand when decisions are made. It also ensures that AORN's resources are used efficiently and applied to programs and services that best serve the needs of the members and provide the greatest value to AORN's diverse member constituency.

KNOWLEDGE-BASED DECISION MAKING

The Board always has strived implicitly to make knowledge-based decisions, but we decided that making knowledge-based decisions is so important it should be made explicit. To that end, we have established a requirement that all recommendations to be considered by the Board must include answers to the following four questions.

1. What do we know about the current realities and evolving dynamics of AORN's environment that is relevant to this decision?

2. What do we know about the capacity and strategic position of the Association that is relevant to this decision?

Health Care Industry

Knowledge-based decision making - President's Message - Editorial

AORN Journal, Sept, 2003 by Betty J. Shultz

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