Donna Lynn Smith
After completing my BScN, I began my career as an instructor in diploma nursing programs at College St. Jean, Edmonton General Hospital, and Grant MacEwan Community College. I taught Fundamentals of Nursing, Maternal and Child Health, Interpersonal Relations and Mental Health Nursing in the classroom and supervised students' clinical practice on acute care medical, surgical, pediatric, and post-partum units; on acute psychiatric units; and in community care and long term care settings.
In 1973, I accepted my first administrative position as Director of Nursing at Lethbridge Auxiliary Hospital.
Between 1978 and 1988, I held senior positions in Nursing Administration at the University of Alberta Hospital with responsibility for diverse clinical areas and specialty programs, as well as the Department of Nursing Research, Development and Education.
In 1979, I established the Nursing Research and Scholarly Activities Committee which involved nurses from all clinical areas and levels of education in the development of research capacity and the dissemination of research results to improve practice. This committee provided support for individuals in newly created Clinical Specialist positions, for two Clinical Nurse Researchers who held shared time appointments in the Faculty of Nursing and the hospital, and for the development of advanced clinical roles in neonatal care and nephrology.
In 1988, I was recruited to the position of Manager of Program Development and Special Programs in the newly created Long Term Care Branch of the Alberta Ministry of Health. I recruited and developed a team of experts who planned and implemented a series of province-wide programs to address emerging needs in the community and continuing care sectors.
In 1995, I was seconded from Alberta Health to become the first Executive Director of the Coordinating Council of Health Sciences, an innovative partnership of Deans of Nursing, Medicine, Dentistry, Pharmacy, Rehabilitation medicine and Physical Education at the University of Alberta. I held this position until 1997 when I became a tenured Associate Professor in the Faculty of Nursing.
At that time, I assumed responsibility for coordination and development of the Leadership Stream in the Masters Program, and developed and taught Nursing 554, Leadership in Health and Nursing Services, and Nursing 584, Advanced Theory and Practicum in Management. I have worked with many students in individual study courses (Nursing 561) and I developed and taught a course Continuity of Care: Research, Policy and Practice (Nursing 560) in conjunction with my research program on continuity of care. I also developed and taught an innovative course, Leadership Issues in Community and Continuing Care, which is offered to professionals working in the continuing and community care systems and to students in the faculty. I have also taught Nursing 550, Issues in Advanced Nursing Practice. It has been satisfying to watch the enrolment in the Leadership Stream of the MN program increase steadily, and to see MN graduates with leadership specialization develop successful management careers.
I am particularly proud of the work I have done with Dr. Judith M. Hibberd, a former mentor and colleague, to create the textbook Nursing Leadership and Management in Canada which is used in universities and colleges across the country. The third edition of this book was released in spring 2005.
Clinical Focus
Since 1969, I have been actively involved in teaching, leadership, and research focused on the health of older people and people with disabilities or chronic illness. This work led to interests in the practice and scholarship of case management, service integration, and continuity of care.
Practice in Policy Analysis and Administration
In my current role, I maintain competency in administrative practice by participating in organizationally integrated research, through policy analytic activities undertaken by professional organizations of which I am a member, and through leadership roles in professional and community organizations. I also undertake selective management consulting and organizational research engagements.
Guiding Principles and Values
During my career, I have experienced and participated in many changes in the nursing profession and the health system. I have been fortunate to work with colleagues, leaders, and mentors who demonstrated the values of continuous learning, collegiality, leadership, innovation, and accountability. I try to enact these values in my work with students and colleagues, with organizational and research partners, and through community service.
Throughout my career, I have advocated for the development and dissemination of knowledge in the nursing discipline, and its application to improve health and clinical care. I have also been committed to interdisciplinary collaboration and knowledge development. I am particularly proud of my leadership role with Dr. John Dossetor, in the development of the Joint Faculties Bioethics Project which was the precursor to the John Dossetor Centre for Health Ethics on the University of Alberta campus.
I value the education I received at the University of Alberta and in other settings. In my previous leadership roles, I have worked to create opportunities for registered nurses and other health professionals to access university education and to develop their clinical and leadership careers with a focus on knowledge-based practice. I now continue with this work in my academic role with students, colleagues, and health system partners in several areas of scholarly interest.
Research
My areas of scholarly interest are described below.
- Policy Analysis and Implementation
Policy analysis is a problem-solving discipline that draws on theories, methods, and findings of the behavioural and social sciences, social professions, and other disciplines. Stages and activities in the policy process include problem structuring, agenda setting, planning, approving, implementing and evaluating policies. Policy analysis has evolved as a specialized field of scholarship in which multiple methods and data sources are used to understand the context, origins, implementation, and outcomes of policies. Policy analysis may be retrospective, focusing on the development, implementation and outcomes of policies already in effect; or it may be prospective, designed to generate information that can be used to make and implement policy choices. Knowledge synthesis activities and case study methodology are two frequently-used approaches to policy research.
- Continuity of Care, Service Integration and Case Management
Continuity of care is a health services outcome that is highly valued by citizens. Integrating health and human services is one way of achieving continuity of care. Case management is a professional intervention used in most western countries to manage and co-ordinate services for vulnerable populations, people with chronic illnesses and people with multiple health problems, including the elderly, who are at particular risk for discontinuity of care.
In recent decades, as the health system became more complex, policies for restructuring and reform have been designed to achieve improved continuity of care. Based on consultation with health system stakeholders, research granting agencies have made it a priority to fund studies in this area. Despite this attention, our practical and theoretical understanding of continuity of care and how to achieve it remains rudimentary. Continuity of care research is concerned with client and caregiver variables, and also with "system level" and organizational variables.
- Organizational Behaviour and Outcomes (Safety and Quality)
Organizational behaviour is a field of study derived from the behavioural sciences of psychology, sociology, and anthropology. It is concerned with development of knowledge about how people behave in organizations and why they behave as they do. Variables such as leadership or administrative behaviour, employee behaviour, and organizational culture are of interest to researchers in this field of study. Organizational outcomes for employees (for example, retention rates and job satisfaction) and for patients (mortality, morbidity, safety, quality, cost, etc.) are also of interest.
- Nursing Leadership and Administration
The field of nursing leadership and administration was one of the first areas in which registered nurses conducted research and applied it to practice. In 1986, the American Association of Nurse Executives defined nursing administration research as scientific inquiry into the factors that influence the effective and efficient delivery of high quality nursing services. Dr. Heather Spence-Laschinger, a leading Canadian researcher, has explained that nursing administration research can be grouped into the topic areas of nursing productivity, nursing care quality, patient outcomes, and studies examining the interactions between these factors.
Today there are a number of specialized professional journals and many text and reference books in this field. I am particularly proud of my work (with Dr. Judith M. Hibberd) as co-author/editor of the only Canadian textbook in this field, Nursing Leadership and Administration in Canada.
- Teamwork, Collaboration and Partnership
The formal study of group process and behaviour in small groups originated in the academic disciplines of psychology and social psychology. The importance of workgroups and teams within organizations and professional practice is well recognized, and more recently the need for inter-professional collaboration has become a theme in the literature of nursing and other health professions. Variables in the study of groups and teams include such things as group composition and structure, the organizational context of groups, and the resources available to them; group tasks and process, and group outcomes and effectiveness. There have been relatively few studies of groups and teams in health care organizations. Collaboration and partnerships are more recent themes in the nursing and health care administration literature. In research, collaboration and partnerships are seen as a way of assuring the relevance of research to practise and accelerating the pace of knowledge transfer.
- Gerontology/Gerontological Nursing (Policy and Programs)
Gerontology is the interdisciplinary study of aging, encompassing biological, psychosocial, health and economic aspects of aging. My scholarly work in this field has included policy analytic activities such as knowledge synthesis, planning and program evaluation, as well as exploratory and descriptive research.
- Nursing/Health Informatics, Knowledge Transfer and Knowledge Appraisal
The field of nursing and health informatics is concerned with structuring, managing, and processing information to support healthcare decision-making. I have been involved in applied and scholarly informatics projects, including implementation of nursing workload measurement and quality assurance systems in acute and long-term care and resident classification and funding in the continuing care system.