Organizational and systems leadership are critical for DNP graduates to improve patient

and healthcare outcomes. Doctoral level knowledge and skills in these areas are

consistent with nursing and health care goals to eliminate health disparities and to

promote patient safety and excellence in practice.

DNP graduates’ practice includes not only direct care but also a focus on the needs of a

panel of patients, a target population, a set of populations, or a broad community. These

graduates are distinguished by their abilities to conceptualize new care delivery models

that are based in contemporary nursing science and that are feasible within current

organizational, political, cultural, and economic perspectives.

Graduates must be skilled in working within organizational and policy arenas and in the

actual provision of patient care by themselves and/or others. For example, DNP

graduates must understand principles of practice management, including conceptual and

practical strategies for balancing productivity with quality of care. They must be able to

assess the impact of practice policies and procedures on meeting the health needs of the

patient populations with whom they practice. DNP graduates must be proficient in

quality improvement strategies and in creating and sustaining changes at the

organizational and policy levels. Improvements in practice are neither sustainable nor

measurable without corresponding changes in organizational arrangements,

organizational and professional culture, and the financial structures to support practice.

DNP graduates have the ability to evaluate the cost effectiveness of care and use

principles of economics and finance to redesign effective and realistic care delivery

strategies. In addition, DNP graduates have the ability to organize care to address

emerging practice problems and the ethical dilemmas that emerge as new diagnostic and

therapeutic technologies evolve. Accordingly, DNP graduates are able to assess risk and

collaborate with others to manage risks ethically, based on professional standards.

Thus, advanced nursing practice includes an organizational and systems leadership

component that emphasizes practice, ongoing improvement of health outcomes, and

ensuring patient safety. In each case, nurses should be prepared with sophisticated

expertise in assessing organizations, identifying systems’ issues, and facilitating

organization-wide changes in practice delivery. In addition, advanced nursing practice

requires political skills, systems thinking, and the business and financial acumen needed

for the analysis of practice quality and costs.

The DNP program prepares the graduate to:

1. Develop and evaluate care delivery approaches that meet current and future needs of

patient populations based on scientific findings in nursing and other clinical sciences,

as well as organizational, political, and economic sciences.

2. Ensure accountability for quality of health care and patient safety for populations with

whom they work.

a. Use advanced communication skills/processes to lead quality improvement

and patient safety initiatives in health care systems.

b. Employ principles of business, finance, economics, and health policy to

develop and implement effective plans for practice-level and/or system-wide

practice initiatives that will improve the quality of care delivery.

c. Develop and/or monitor budgets for practice initiatives.

d. Analyze the cost-effectiveness of practice initiatives accounting for risk and

improvement of health care outcomes.

e. Demonstrate sensitivity to diverse organizational cultures and populations,

including patients and providers.

3. Develop and/or evaluate effective strategies for managing the ethical dilemmas

inherent in patient care, the health care organization, and research.