The healthcare industry is transforming. Procedures that once filled hospital inpatient units continue to migrate to outpatient facilities like Ambulatory Surgery Centers (ASCs) and Hospital Outpatient Departments (HOPDs). This shift toward outpatient care — which represents an estimated $50 billion in surgical volume — demands more than just operational adjustments. For chief nursing officers (CNOs) and nursing leaders, it’s a call to action. How can your healthcare organization maintain exceptional patient care outcomes, retain your best nurses and clinical professionals, and adapt to new care delivery models?
The answer lies in bold leadership, strategic workforce planning, and a clear focus on what matters most: patients and staff. Let’s take a closer look at how CNOs can turn these challenges into opportunities for growth and excellence.
The Impact of the Outpatient Revolution on Nursing Teams
Healthcare is constantly changing, so what makes this migration of procedures to outpatient care any different? First, the financial pressures of the site-of-care shift facing healthcare will drive surgical volume from hospitals to lower-cost outpatient facilities. The second significant impact of that shift is the ripple effect it will create across the nursing workforce. What does that mean for your team? Let’s take a look.
1. Healthcare Organizations Face New Skill Mix Demands
Inpatient hospitals are turning into hubs for high-acuity, complex cases. Nurses in these settings need to master specialized skills and adopt advanced technologies. Meanwhile, outpatient facilities need nurses who can handle quick turnarounds, patient education, and same-day discharges. Balancing these skill sets is no small task—but it’s essential for staying relevant as your organization faces changes.
2. Staffing Models Face (Even More) Shake-Ups
Traditional clinical staffing models aren’t built for this new world. Units designed for routine, lower-acuity cases may now face higher patient acuity or the risk of being downsized. At the same time, outpatient facilities are ramping up their staffing to handle increased demand. Nursing leaders need to rewrite the playbook on staffing models to get this shift in volume and case complexity right.
3. Career Path Uncertainty
If inpatient experience becomes less valued in your organization and other healthcare organizations across the country, your nursing staff might question their career path’s viability. CNOs and nursing leadership need to address these concerns by redefining what professional growth looks like in a care landscape that’s changing before our eyes.
Strategic Priorities for Nursing Leadership
So, how do you tackle these challenges head-on? By being proactive, adaptable, and forward-thinking. Here are two tips to guide your next steps:
1. Build a Workforce That Bends, Not Breaks
With nearly 20% of new nurses leaving their jobs within the first year, flexibility is no longer optional for modern nursing leadership. It’s a survival skill. If your organization wants to sustain and retain its workforce, it’s time to start meeting them where they are.
- Cross-Train for Resilience: Equip your nurses with the skills to thrive in both inpatient and outpatient roles. This assures they can pivot with confidence as your organization’s needs change.
- Mentor Through Transitions: Change isn’t always easy. However, it can be easier for nurses when they have the support they need. Implementing mentorship programs and creating opportunities for collaborative learning can help nursing teams adapt to the site-of-care shift and build their confidence.
- Celebrate Adaptability: Recognition goes a long way. Make a point to highlight and reward staff who embrace the changing landscape. Then, take it a step further: help create peer-to-peer coaching opportunities so clinical staff who are excelling can lead those who are at risk of falling behind.
2. Champion Specialized Skill Development
As inpatient care focuses on complexity and outpatient care emphasizes efficiency, nursing leaders have to do more to keep their staff—and keep them engaged. Three ways to boost retention through development include:
- Offering Advanced Certifications: Help nurses gain expertise in high-acuity specialties like critical care, oncology, or trauma. Consider preparing for a discussion with your CFO to secure budgetary resources for investments in continuing education.
- Streamlining Outpatient Training: Develop quick-start programs to teach foundational outpatient-specific skills like rapid discharge planning and patient education.
- Partnering with Educators: Partnering with nursing schools is a win-win. Your organization can build relationships with a talent pipeline while assuring curricula align with the realities of modern healthcare. Meanwhile, nursing schools get access to a healthcare partner who can contribute to creating a richer education experience.
Embrace Outpatient Growth as a Leadership Opportunity
Outpatient care is here to stay, and its rise offers CNOs a chance to lead boldly. How can you position your nursing team—and yourself—for success?
1. Establish Leadership Roles for Outpatient Services
Create positions that are dedicated to outpatient nursing leadership. Doing so can assure consistent quality standards across your organization and give nurses a more concrete career path.
2. Prioritize Staff Development
As mentioned earlier, equipping clinical staff to handle the unique needs of outpatient care delivery, from patient education to recovery protocols, is vital for many organizations’ ability to adapt to the site-of-care shift. Staff development cultivates a growth mindset that leads to better patient outcomes and sustainable retention.
3. Redefine Your Quality Metrics
The definition of success in the outpatient setting isn’t a dramatic departure from the inpatient setting. However, it’s worth looking beyond traditional metrics like length of stay and bed occupancy rates, which are less meaningful in the outpatient setting.
As your organization experiences shifts in the site of care delivery, use nursing-sensitive key performance indicators (KPIs) tailored to the outpatient setting. Patient satisfaction, discharge efficiency, and safety metrics will be the new North Star.
Leverage Technology to Smooth the Transition Between Sites of Care
Technology can be healthcare organizations’ greatest ally during this shift, so don’t ignore it. Opportunity-rich technological applications in the healthcare sector include:
- Telehealth enables your organization to extend its nursing expertise to outpatient and remote settings without overextending your staff.
- Predictive Analytics can help your organization utilize data to optimize staffing based on your organization’s busiest times, anticipate patient flow, and identify patient health history risks that can improve their health outcomes.
- Virtual Training can assist with a major sticking point in site-of-care shift education: time. If your organization is anything like others, your clinical staff are chronically short on time, which complicates continuing education initiatives. Offering online training can help your nurses develop cross-setting competencies without stepping away from patient care.
Action Steps for CNOs
With so much opportunity and so much at risk due to site-of-care shifts, the amount of work can be overwhelming for CNOs. The saving grace of the site-of-care shift is that it won’t happen overnight. While you shouldn’t kick the can down the road, it does mean that you can take a strategic and more thoughtful approach to the changes facing the sector.
So, what should you focus on first? Let’s break it down into three manageable phases.
- Immediate Term (0-6 months): Assess your team’s current skill mix, identify staff at risk of turnover, and start designing cross-training initiatives.
- Medium Term (6-18 months): Design new staffing models focused on efficiency and clinician satisfaction. In addition, continue to roll out career development pathways, and track metrics for retention and satisfaction.
- Long Term (18+ months): Establish sustainable leadership structures, create centers of excellence for nursing specialties, and continue implementing innovative care delivery models that amplify nursing impact.
The Bottom Line
Change is never easy—but it’s also an opportunity. The sector’s current shift to outpatient care will challenge nursing leaders to think differently, act decisively, and lead purposefully. By focusing on your workforce’s flexibility, clinicians’ skill development, and operational efficiency, your organization’s nursing leadership can confidently navigate this transition.
So, the question isn’t whether your organization can adapt to this new reality. It’s how well you’ll seize the opportunity. Your organization’s ability to seize the opportunity depends on your CNO’s ability to recognize it. If your organization needs nursing leadership that’s ready to bring you into the next phase of healthcare with success, don’t delay. Turn to the nurse executive recruiters at Kirby Bates Associates.