Prelude to Renewal

May 2018Catherine L. Gilliss

Organizations develop and change over time, just like people. Evolution is shaped by the outside world as well as the interiors where we value, believe and act collectively. The qualities of organizations vary according to your perspective. We know this because we have begun a process of organizational self-examination.

At UCSF’s School of Nursing, we are in the early stages of a process of renewal that will soon move into development of a strategic plan. The point of strategic planning is to set priorities for decision making about resources (time, money, human capital), but the process begins with an inward reflection. Borrowing on Peter Drucker (Five Most Important Questions: Enduring Wisdom for Today’s Leaders, 2015), we begin by considering four questions: 

  1. What is our mission? 
  2. Who is our customer? 
  3. What does our customer value?
  4. What are our results?

And the answers to these four offer direction to the final question:

  1. What is our plan?

Discussion of mission – in accordance with our vision and values – grounds our work and sets some basic boundaries. For instance, as we enter our planning process, we will need to balance what experience has taught us about the role of practice activities in our core mission with our clear charge to educate and to develop knowledge.

The question “Who is our customer?” is complicated, as is the language used to describe the beneficiaries of our effort. Is our customer a composite of students, learners, trainees, patients and clients – or is it “the public”? As a public institution charged with educational and knowledge development responsibilities, we often experience the two responsibilities to be in conflict (e.g., How can I finish that manuscript while teaching so many courses?). 

What our customers value has changed over time, and those changes have demanded changes of us. Our students are more diverse than ever, expecting that we understand their background and are competent to address the differences, whether they be financial, cultural, learning differences or physical differences that require accommodations. Our customers’ expectations for research include greater levels of patient engagement, public access to data, compliance with a growing set of regulations, and more design and analytic sophistication than ever. In the provision of health care, we see expanded levels of patient self-determination, which require new ways of interacting with those we serve. Over time and taken collectively, these shifts are significant influences on the ways in which we work.

Not surprisingly, some of our results are more encouraging than others. We enjoy continued success in scientific productivity and are turning attention to succession planning in our research. Our educational programs, while high quality, use delivery models that limit access to a growing number of prospective students, which, in turn, limits our ability to prepare the future health care workforce. Our diverse body of faculty, staff and students are eager to grow, contribute and find their way in a world that is increasingly fast-paced and confusing. Sometimes that complexity and the pace are dispiriting.

Back in the early 1990s, when Marilyn Chow was honored as our Distinguished Alumna, she reminded us of the fable about the frog who did not jump from the boiling water when the temperature increase was gradual, in contrast to the frog thrown into boiling water, who immediately jumped out. Our water temperature is rising now, and that must be the impetus for us to jump out of the pot and plan our future

That matters because for more than 100 years, our School has been among our profession’s leaders. Nurses and nursing science will continue to play a central role in how we deliver health care in this country and around the world; therefore, institutions like ours must stop periodically to incorporate how the world has changed into everything that we do. That doesn’t mean that we abandon our core values, the ones that have driven nursing from the outset – those remain our touchstone – but it does mean that we have to create room to grow and change. We expect that in the coming year, the stories we tell of the exciting work of our extraordinary faculty, staff and students will reflect that growth and change.

Catherine L. Gilliss, PhD, RN, FAAN

Dean and Margretta Madden Styles Professor of Nursing

Associate Vice Chancellor, Nursing Affairs, UCSF