Nurses on Boards: Diversity of Leadership is Critical to Transforming the Health Care System

Oct 17, 2013, 12:00 PM, Posted by

Alexia Green, RN, PhD, FAAN, professor and dean emeritus, Texas Tech University Health Sciences Center and co-leader of the Texas Action Coalition. She is an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program.


As a nurse, I have long desired to be a full partner with physicians and other health care leaders in improving health care delivery in our country.  The truth is many nurses have this desire, but all too often we are not viewed as key players in the larger policy arena.  When the Institute of Medicine Future of Nursing report was issued in 2010, I was very excited to see a major emphasis placed on nurses become full partners in redesigning health care in the United States. 


I personally became intrigued with impacting health care policy while a graduate student at the University of Texas Health Sciences Center in Houston—where my professor, Dorothy Otto, encouraged me to become engaged, providing me with a vision that policy was something I could shape and develop rather than passively watch.  My engagement with the Texas Nurses Association and the Robert Wood Johnson Foundation Executive Nurse Fellows program helped solidify my leadership skills to be well prepared to actively serve on boards where policy decisions are made in hopes of improving health systems to advance patient care.

Because of my early career engagement in the policy arena and service on many state policy boards, I was privileged to be appointed by the Texas Governor to the Texas Institute of Healthcare Quality and Efficiency in 2012.   This 15-member board is composed of eight physicians, four health care system and insurance CEOs, two consumer advocates, and one nurse!  Together we are charged with improving health care quality, accountability, education, and cost containment in the State.  In short, we are working on reforming the health care system in Texas.

While I am very proud to be at this policy table, I look forward to the day when such policy boards consist of more nurses. Nurses who are highly valued for their unique knowledge, understanding, and perspectives on how to improve health care delivery in our nation.

As a Co-Leader for the Texas Action Coalition engaged in the Future of Nursing: Campaign for Action, I know work is currently being undertaken to develop a shared national strategy for increasing the number of nurse leaders serving on hospital/systems, state, and federal boards.  Our profession needs to identify promising leadership development programs to specifically prepare nurse leaders to assume these leadership positions. Our nation’s leaders and citizens need a deeper understanding of why diversity in leadership is critical to transforming the health care system.  And our profession needs to prepare more nurse leaders to assume this important leadership role of “nurses on boards.”

This commentary originally appeared on the RWJF Human Capital Blog. The views and opinions expressed here are those of the authors.