The Journal of Continuing Education in Nursing

Administrative Angles 

Return on Investment: Building the Case for a Nurse Manager Certificate Program

Evelyn Lengetti, PhD, RN-BC; Patricia Haynor, PhD, RN, NHA

Abstract

Nursing professional development practitioners are frequently asked about program return on investment. A pre–postprogram self-assessment was developed for a Nurse Manager Certificate Program using the American Nurses Credentialing Center Nurse Executive Certification blueprint. The results identified knowledge and skill gaps, defined program outcomes, and helped determine return on investment. The results revealed improvement of knowledge, skill, and evidence for return on investment.

J Contin Educ Nurs. 2018;49(10):446–448.

Abstract

Nursing professional development practitioners are frequently asked about program return on investment. A pre–postprogram self-assessment was developed for a Nurse Manager Certificate Program using the American Nurses Credentialing Center Nurse Executive Certification blueprint. The results identified knowledge and skill gaps, defined program outcomes, and helped determine return on investment. The results revealed improvement of knowledge, skill, and evidence for return on investment.

J Contin Educ Nurs. 2018;49(10):446–448.

Understanding the value of professional development activities guides senior leadership decisions in lean economic environments” (Opperman, Liebig, Bowling, Johnson, & Harper, 2016a, p. 128). All too often, nursing professional development practitioners are asked to prove the benefits of a learning activity—especially when it is a multiple-day event. Conducting a nurse manager certificate program for a large group of leaders from the same organization with confirmation of return on investment was a daunting request to tackle. The challenge of this request was to create a tangible way to measure and demonstrate the effect of a comprehensive 6-day learning activity to the organization's financial bottom line.

To initiate the process, and as recommended by Opperman, Liebig, Bowling, Johnson, and Harper, (2016b), a cost analysis was completed that helped determine the least expensive and most efficient way to deliver the program. It was decided that offering an exclusive program onsite to the leaders as a group, rather than individual managers, was both cost effective and efficient. It was also evident to the planning committee that offering the program to a cohesive group would promote discussion that was in real time and reflected actual issues the group faced within the organization. The more challenging task was to calculate the benefit–cost ratio, which evaluates the programs influence on employee turnover and improved quality and safety metrics.

To help determine the benefit–cost ratio, identify the underlying education needs, and provide measurable and observable learning outcomes, a self-assessment was developed using the American Nurses Credentialing Center blueprint for the Nurse Executive Certification Exam. This 96-item self-assessment measured both knowledge and skill using a 5-point Likert scale, where 1 = strongly disagree and 5 = strongly agree. The survey was distributed to all participants before and after the program was completed in entirety (preprogram survey [N = 29] and postprogram survey [N = 18]). All participants received the confidential survey via e-mail 6 weeks prior to the start of the program. This gave the program planning committee time to collate the data and prepare and present the findings to the organization's leadership team. Engaging the leadership team promoted a platform to review both knowledge and skill practice gaps and discuss the anticipated learner outcomes. Review of pre-data set the stage for the educational activity content to be delivered in the classroom. It also identified what content was the responsibility of the onsite leaders to promote and reinforce in the practice setting.

The Program

The Nurse Manager Certificate program was a series of six full-day classes that focused on the core concepts of leadership, contemporary theories, and effective management strategies. Learner engagement activities included lecture, discussion, audiovisuals, role-playing, case studies, individual and group activities all supporting individual learning styles and a variety of personal experiences, as well as the application of content to real-life situations.

The relationship between organizational theory and structure, and the manager's role and responsibilities, were examined on the Day 1, “Organizational Leadership and Management Theory and The Role of the Nurse Manager.” Fundamental concepts of leadership, including leadership types, job-related skills, common myths, and personal attributes, were discussed as means for survival in a dynamic health care environment. Participants were engaged, and anecdotal feedback noted that they thought they had gained insight into how to enhance daily clinical unit operations and improve employee satisfaction and productivity—a key responsibility for which many managers are accountable.

Day 2, “Decision Making/Problem Solving/Critical Thinking Skills,” gave the participants an opportunity to connect decision making and creative/critical thinking skills to the role of the nurse manager. Participants learned how to complete a gap analysis, reviewed various decision-making models, and developed new problem-solving strategies all with easy application to the work environment.

The most popular session was about making teams work more effectively and how to empower others. “Team Building: Selecting, Developing, Motivating, Empowering, Coaching Staff” on Day 3 shared the secrets to successful employee recruitment and the manager's responsibilities to develop and socialize employees to the work environment. Managers reviewed theories of motivation and how to apply them in day-to-day practice. Discussions in this session helped the manager differentiate their role as a coach from that of counselor.

Everyone strives to improve their appraisal skills so performance reviews are fair and equitable. Day 4, “Performance Appraisal—Staffing and Scheduling,” discussed the crucial concepts in the appraisal process and challenged personal biases and prejudices managers often bring to that process. Who doesn't want to learn the best way to influence and motivate others, as well as improve productivity?

All managers had an opportunity to expand their budgeting skills on Day 5 with “Financial Management.” Participants benefited from a review of basic concepts of financial management and select economic principles and applied them to contemporary health care finance. An in-depth look at a health care budgets and a review of the budget building process provided a foundation for successful analysis of financial statements.

The sixth and final day provided an exploration of “Human Resources Management.” This topic helped everyone discover new ways to enhance and refine their skills for resolving conflict, negotiating with others and improve their approach to time management, all necessary skills for current successful health care leaders.

Program Evaluation

The methods of evaluation of this educational activity were both formative and summative and reflected both the overall program desired learning outcomes, as a well as daily program objectives. At the end of each program day, the participants were asked to select an idea, concept, or theory discussed that day and document their intent to apply this new knowledge or skill to their practice. This exercise was later discussed as a self-report of their change in practice. A summative assessment was also conducted at the end of the entire program and measured the overall program learning outcomes and the individual participant's intent to change practice.

The postprogram self-assessment was sent via confidential e-mail to each participant to complete at the end of the entire program. These data were compared to the preprogram assessment and provided evidence that confirmed improvement in job-specific knowledge and skills and highlighted the practice gaps for future development (Table). A comparison of the pre- and postdata was shared with the organization's leadership to validate the practice change because of attending this certificate program and as a guide to future development of this nurse manger team. Collectively, all evaluation data helped to measure the effects of this activity and helped refine future offerings of this certificate program.

Program Evaluation Results Sample

Table:

Program Evaluation Results Sample

Conclusion

The group was acknowledged for their commitment to their professional development with a celebration at the end of the program. All participants were awarded 34.5 contact hours, along with a certificate of completion hand delivered by members of the organization's senior leadership team. Upon review, the planning committee affirmed that an assessment of professional job-related knowledge and skills proved to be the prefect starting point to begin to demonstrate return on investment. Overall, the postprogram data confirmed self-reported improvements of key job-related responsibilities.

Showcasing improvement of both knowledge and skill for all participants gave tangible support for the benefits of this program on professional development, yet actual financial savings remains an unanswered question at this time. It was discussed that a financial return on investment may be achieved my measuring employee retention and turnover rate in each clinical unit or employee engagement outcomes for individual clinical areas. Program effects on employee turnover and satisfaction take more time and effort to measure and are better long-term evaluation measures of benefit–cost ratio.

References

  • Opperman, C., Liebig, D., Bowling, J., Johnson, C.S. & Harper, M. (2016a). Measuring return on investment for professional development activities: A review of the evidence. Journal for Nurses in Professional Development, 32, 122–129. doi:10.1097/NND.0000000000000262 [CrossRef]
  • Opperman, C., Liebig, D., Bowling, J., Johnson, C.S. & Harper, M. (2016b). Measuring return on investment for professional development activities: Implications for practice. Journal for Nurses in Professional Development, 32, 176–184. doi:10.1097/NND.0000000000000274 [CrossRef]

Program Evaluation Results Sample

Participant Self-Assessment Statement% Preprogram (N = 29)% Postprogram (N = 18)


SDDNASASDDNASA
I am confident of my skill for establishing staffing models (e.g., primary care nursing, team nursing, nurse-patient ratios, skill mix, acuity).471163150006040
I am confident in my skill for recruiting, recognizing, and retaining staff.00458380004060
I am confident in my knowledge of new program development (e.g., proposals, pro forma, business plans, marketing).4165616888203232
I am confident of my skill in creating a culture and advocating for resources that support research and scholarly inquiry (e.g., journal club, grant writing, research councils, research participation).03827278013312531
Authors

Dr. Lengetti is Director of Continuing Education, and Dr. Haynor is Adjunct Associate Professor M. Louise Fitzpatrick College of Nursing, and Dr. Lengetti is also Assistant Dean, Villanova University, Villanova, Pennsylvania.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Address correspondence to Evelyn Lengetti, PhD, RN-BC, Director of Continuing Education, M. Louise Fitzpatrick College of Nursing, and Assistant Dean, Villanova University, 800 Lancaster Avenue, Driscoll Hall Room 220, Villanova, PA 19085; e-mail: evelyn.lengetti@villanova.edu.

10.3928/00220124-20180918-02

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