Implementing the Clinical Nurse Leader (CNL) Role in Japan

Background: The provision of high quality, efficient, and cost-effective healthcare care is a complex process in health systems across the globe (Lindberg, et al., 2008). Care delivery models, supply and demand of human and fiscal resources, and population specific health care needs within various sociocultural contexts are complicated issues. These issues require individuals with expert knowledge and skills in order to be solved. Therefore the CNL role could be a catalyst to improve healthcare outcomes in other countries through systems expertise, advanced clinical skills that optimize interdisciplinary collaboration and the development of partnerships as a leader across the healthcare delivery system (Harris, et al., 2014).

Program: To promote the implementation of the CNL role in Japan a multifaceted approach was used. First, over three years (2012, 2013, and 2014) the assumptions of the CNL role were disseminated in major medical centers, universities, and professional nursing organizations across Japan.  In particular, the intersection of care, health, and cost known as the triple aim, was a topic of priority. In addition, examples of CNL successes were shared as exemplars.  Through this process of dissemination 14 institutional partnerships in Japan were developed. In response to these partnerships a special agreement was requested from the Commission on Nurse Certification (CNC) and AACN to promote qualified Japanese Nursing leaders in achieving the faculty CNL certification. Subsequently in 2014 a 7-day CNL seminar was delivered at Saint Anthony College of Nursing comprised of theory, case studies and a clinical immersion experience to prepare qualified Japanese nursing leaders to achieve CNL certification.  After successful certification the goal is to partner with certified faculty and universities to develop a socio-culturally congruent CNL curriculum meeting the AACN (2013) competencies and curricular expectations for CNL education and practice.

Outcomes: 1) Finalized a collaborative agreement with CNC and AACN to promote CNL faculty certification for qualified nursing leaders in Japan. 2) Presentations in 2012, 2013, and 2014 totaling 40 presentations delivered about the CNL role to a variety of universities and medical centers, and professional nursing associations. 3) Developed formal institutional partnership agreements with 2 major Japanese universities. 4) Delivered the first bilingual comprehensive CNL seminar with clinical immersion component to 7 qualified Japanese nursing faculties. Work in progress: 1) Grant submission by a Japanese partner institution to facilitate the implementation of CNL programs across Japan. 2) Japanese partners are currently preparing for certification on 2015.  3) CNL seminars are planned in Japan and in the U.S. in 2015.

Recommendations: Successful introduction of new nursing roles is possible through careful strategic planning, consensus building, and developing strong personal partnerships with leaders, and between key organizations.