Nurse retention, leadership, and the Toyota System Model: Building leaders and problem solvers for better patient care

Nurses today find themselves in a complex environment in which their work is changing at an exponential rate. They need to provide more care for sicker patients with fewer resources and greater demands on their time. Likewise, hospital and nursing administrators are stressed with issues of access to care, reduced reimbursement, high cost of scarce labor, and an emphasis on managed care versus patient-focused care. Rising patient expectations and a nationwide nursing shortage also have an impact on the profession. 1