Nurses are essential players in all health and policy arenas

Health system design and performance solutions are on the minds of policy makers everywhere. No matter where you look countries are wrestling with rising healthcare costs, ageing populations, the double burden of non-communicable and infectious diseases, higher public expectations (along with the call for patient-centred care and greater engagement in decision-making), and pressure to demonstrate progress in global targets such as the Millennium Development Goals. Communication technology and social networking mean that people are more aware of their rights and of healthcare issues: they want access to an affordable continuum of services, including home care. In response to this global state of affairs, the World Health Organization (WHO) and others are calling for countries to adopt new financing and delivery mechanisms that support universal access and universal health coverage (WHO, 2014). Outcomes, cost and quality continue to dominate healthcare decision-making. Organizations, such as the internationally recognized Institute for Healthcare Improvement, are calling for solutions that simultaneously address quality of care and patient satisfaction, improve population health, and reduce healthcare costs (IHI, 2014). In other words, innovative and cost effective solutions in a variety of health sectors and academia – solutions that enhance and go beyond nurse-led clinics, outreach and health promotion – are needed in today's health arena. Designing, implementing, managing and evaluating these solutions require a scaling up of the leadership and management capacity of nurses and health professionals at all levels and in all health sectors and settings, including regulation and academia. Stephanie Ferguson, PhD, RN The LFC programme is close to celebrating two decades of empowering nurses. Active since 1996 and implemented in more than 70 countries, LFC is a copyrighted and trademarked action-learning leadership programme for nurses and other health professionals. The programme vision is that 21st century nurses will have the knowledge, strategies and ability to lead and manage in complex and dynamic nursing and health service arenas so as to influence the development of the profession and the advancement of health and social policies towards healthier futures for all populations. LFC empowers nurses to engage in the development of health and social policy; be effective and dynamic leaders and managers; align the contribution of the profession in socioeconomic, professional and regulatory developments; and maintain and advance their own competence as well as identify, develop and support future generations of leaders. The successful LFC methodology includes workshops, team projects, individual and group learning activities, mentoring and individual development plans. A unique Training of Trainers approach extends the programme in a format whereby in-country certified trainers implement LFC under a licensing agreement. ICN retains the ownership, copyright and intellectual property, regularly carries out evaluations and onsite reviews, and is available as a technical resource. A 2010 evaluation found the content very relevant but called for fewer workshops and more innovative methods for transmitting knowledge (Ferguson 2012). As a result the LFC programme is now delivered in two workshops over a one-year period. Approximately four to five months after the workshops, the faculty implements a two-day monitoring and evaluation meeting and graduation ceremony. Graduates qualify for International Continuing Nursing Education Credits (ICNECs). They are also eligible to participate in the ICN Leadership for Change Network, which meets every other year during ICN conferences and the Congress, and receive two electronic LFC newsletters annually. Regular research, routine multi-perspective evaluation and constant monitoring keep the programme current. Communications with a wide variety of stakeholders, along with monitoring visits and evaluations, indicate that LFC graduates worldwide are involved in a range of health and leadership activities, roles and partnerships. LFC graduates have made – and continue to make – significant contributions. For example, graduates have reduced maternal mortality and hospital infections; implemented new hospital quality improvement programmes; established training programmes in HIV/AIDS, TB and malaria; developed performance evaluation tools for nurse managers along with tools to strengthen leadership in public health settings; developed models to improve home based care; established national Nursing Councils and strengthened national nursing associations; and developed strategies for the development of positive practice environments for nurses in health systems and academia. Anecdotally, ICN knows that LFC graduates are less likely to emigrate (Ferguson 2008, 2012). To complement the LFC and LIN programmes, ICN introduced the ICN-Burdett Global Nursing Leadership Institute in 2009. It is an advanced week-long global health focused leadership programme for senior and executive nurses. Drawing on the expertise of international faculty, participants review and enhance their national and global leadership knowledge and skills in the context of global health issues and within a collaborative and stimulating learning culture. A GNLI Colloquium, held for the first time at the 2013 ICN Congress, gave alumni an opportunity to network, share personal achievements and identify on-going learning needs, and allowed ICN the opportunity to capture outcomes and best practice exemplars in global health. The GNLI Colloquium occurs during ICN conferences and congresses. This year will see the launch of a new Institute and LFC interactive webpage and learning platform, which will showcase the achievements of past participants and provide on-going forum opportunities for networking and continuing education activities. Whether through the Institute, Leadership in Negotiation or LFC, ICN is fully engaged in developing the leadership capacity of nurses who make a difference for patients, populations and the profession. Interest in LFC, in particular, continues to grow. Today LFC is a vibrant forum for the development of leadership skills for nurses and health professionals everywhere. Demand continues to increase as LFC participants and graduates demonstrate impact on policy-making in societies throughout the globe. The role of nurses as essential caregivers and pillars of health and development, a role that ICN and its members strive to make resiliently clear, mandates a greater participation by nurses in driving policy decisions, setting policy goals and determining and pushing forward new innovations in healthcare. LFC continues to give nurses the knowledge, skills and tools needed to lead change worldwide today and tomorrow. Stephanie Ferguson, PhD, RN, FAAN is Director of the ICN Leadership for Change Programme (LFC) and Facilitator for the ICN-Burdett Global Nursing Leadership Institute. She may be contacted at ferguson@icn.ch.