About ACHE



For immediate release


CHICAGO, May 6, 2004—A new survey finds that 99 percent of hospital chief executive officers and 95 percent of chief nursing officers report that their relationship with each other is good. Nearly as many said that the relationship between the CNO and other members of the senior executive management team is also good. The survey, conducted by the American College of Healthcare Executives and the American Organization of Nurse Executives, studied the responses of 569 CEOs and 460 CNOs.

"Chief nursing officers are expanding their responsibilities and becoming more important participants on hospital senior management teams," says Marilyn Bowcutt, R.N., AONE president-elect and vice president of Patient Care Services for University Health Services in Augusta, GA. "We're delighted that the increasing role of the CNO is being well received and that there is a positive relationship between the CEO and CNO in most hospitals."

Hospitals included in the study varied by size and ownership. More than three-quarters of the CEOs and CNOs surveyed work in not-for-profit settings; about half work in hospitals with more than 200 beds. In the most recent fiscal year, the hospitals represented in the survey had a median net operating margin of 3.3 percent, placing them above the national average. The median nurse vacancy rate among the organizations surveyed was 6 percent; the median nurse turnover rate was 10 percent.

Other key findings from the survey include:

  • Three out of four CNOs report directly to their CEO; most of the remainder report to the COO.
  • CNOs meet with the CEO one-on-one about once a week. CNOs meet with the CEO and other senior executives about six times a month.
  • While more than 80 percent of chief financial officers give regular reports at every board meeting, only about 40 percent of CNOs report to the board that often. Most CNOs report less than every other board meeting.
  • Ninety percent of CEOs said that typically, physicians on the hospital's staff who have a complaint about nursing care are asked to contact the CNO. However, a sizeable minority (21 percent) of the CNOs surveyed said that physicians are asked to report the problem to the director of nurses of the appropriate department first.
  • When asked if they get more support from their supervisor than their colleagues do, 30 percent of the CNOs agreed and 36 percent disagreed. Only 17 percent of CEOs agreed that CNOs get more support from their supervisor than do other members of the senior management team.
  • Both CEOs and CNOs were ambivalent about the CNO's opportunity to advance his or her career in their hospital. CEOs were split, with 41 percent agreeing that there were limited career advancement opportunities for CNOs, while 46 percent disagreed. CNOs were also divided, with 48 percent agreeing and 36 percent disagreeing.

ACHE and AONE hope to use the findings from this research to study factors that influence positive working relationships between CEOs and CNOs, including internal promotion vs. external recruiting and the span of control that CNOs have within the organization. "CNOs are beginning to take a more prominent place in the hospital's senior management team, and this research provides a valuable glimpse into the way CNOs are perceived," says Larry S. Sanders, FACHE, Immediate Past-Chairman of ACHE and chairman and chief executive officer of Columbus (GA) Regional Healthcare System. "It also provides us direction for future studies, which could explore ways hospitals have succeeded in enhancing career opportunities for CNOs and increasing the involvement of CNOs at board meetings."

American College of Healthcare Executives

The American College of Healthcare Executives is an international professional society of 30,000 healthcare executives who lead our nation's hospitals, healthcare systems, and other healthcare organizations. ACHE is known for its prestigious credentialing and educational programs and its annual Congress on Healthcare Management, which draws more than 4,000 participants each year. ACHE is also known for its journal, the Journal of Healthcare Management, and magazine, Healthcare Executive, as well as ground-breaking research and career development and public policy programs. ACHE's publishing division, Health Administration Press, is one of the largest publishers of books and journals on all aspects of health services management in addition to textbooks for use in college and university courses. Through such efforts, ACHE works toward its goal of being the premier professional society for healthcare leaders by providing exceptional value to its members.

American Organization of Nurse Executives

Founded in 1967, the American Organization of Nurse Executives (AONE), a subsidiary of the American Hospital Association (AHA), is a national organization of more than 4,300 nurses who design, facilitate, and manage care. Its mission is to represent nurse leaders who improve healthcare. AONE members are leaders in collaboration and catalysts for innovation. AONE's vision is "Shaping the future of healthcare through innovative nursing leadership." The organization provides leadership, professional development, advocacy, and research in order to advance nursing practice and patient care, promote nursing leadership excellence, and shape healthcare public policy. Its Web site is www.aone.org.


Deborah A. Labb, ACHE, (312) 424-9426
David Strickland, AONE, (312) 422-2815