| Sumario: | Significance & Background: In this large outpatient organization with over 80 locations each clinic is overseen by a Clinical Nurse Manager with no additional clinical leadership between the manager role and the Director of Nursing. An opportunity was identified for regional director level leadership to further support clinical oversight and development. Purpose: Effective clinical leadership is essential to maintaining high quality oncology care. In 2022, the Area Clinical Director [ACD] role was developed as a pilot program to provide regional nursing leadership, standardize practice, and support clinical teams and initiatives across multiple locations. Interventions: The ACD role oversaw nine oncology clinics, focusing on a 'boots on the ground approach.' This role was created with an objective to provide quality monitoring, and communication between teams and leadership. The pilot aimed to expand nursing leadership and provide support to Clinical Nurse Managers with staffing, scheduling, policy and procedures guidance and advocacy for the clinical team. Monthly Clinical Nurse Manager meetings were held ensuring timely dissemination of essential information to all nursing staff, while bi-weekly 1:1s and impromptu visits provided additional support. Results: The pilot program was highly successful and resulted in key achievements including the development, monitoring and support of clinical key performance indicators and better staffing utilization to reduce overtime. Multi-departmental initiatives promoted professional growth for nursing leaders. Oversight of daily clinic operations streamlined infusion room processes, while dynamic staffing allocations enhanced efficiency and patient safety. Consistent clinical support strengthened nurse manager relationships and built trust with clinical teams. Outcomes included a year over year decrease in preventable clinic charges and expansion to six ACDs, each assigned to a defined geographic area to ensure focused oversight and consistent practice support. Discussion: The regional clinical leadership model strengthened oncology nursing practice, improved efficiency, and promoted adherence to organizational standards. The ACD framework is scalable and adapt-able, offering a replicable approach for organizations seeking to balance centralized quality standards with localized leadership presence.
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