Sean Clarke

Faculty

Sean Clarke Headshot

Sean Clarke

FAAN PhD RN

Ursula Springer Professor in Nursing Leadership
Executive Vice Dean

1 212 998 5264

Sean Clarke, RN, PhD, FAAN, is the executive vice dean and a professor at NYU Rory Meyers College of Nursing. His research focuses on quality and safety issues in acute care hospitals, workforce issues, occupational safety of nurses, and the influences of economic and political factors on healthcare delivery and the nursing profession. He is perhaps best known for research on nurse staffing in hospitals and surveys of nurse working conditions. He has authored or co-authored over 100 peer-reviewed articles and 30 book chapters. Clarke has been a principal investigator on projects supported by the National Institute of Nursing Research, the Centers for Disease Control and Prevention, the Robert Wood Johnson Foundation, and the Ontario Ministry of Health and Long-Term Care and has served as a co-investigator on grants totaling over $10 million over the course of his career. In addition to teaching nursing, health policy, and research at the baccalaureate through doctoral levels, he also supervises PhD and postdoctoral research trainees and maintains a program of research with colleagues from a number of countries. 

Clarke has been a member of a variety of panels and boards related to health research and healthcare quality. He has had extensive involvement in peer review of research articles and grants and served on editorial boards of a number of scientific and professional journals in nursing and health services research. He is a fellow of the American Academy of Nursing and currently holds affiliate faculty appointments at the Université de Montréal and the University of Hong Kong.

Prior to joining the faculty at NYU Meyers, he was a professor and associate dean in the Undergraduate Program at the Connell School of Nursing, Boston College, from 2014–2018. He was also on faculty at the University of Pennsylvania School of Nursing for seven years, held an endowed chair in cardiovascular nursing at the University of Toronto, and was an endowed chair directing a special donor-funded set of projects intended to advance collaboration between the School of Nursing and its affiliated teaching hospitals at McGill University. He also co-directed nursing health services and workforce research groups in Philadelphia and Toronto and has been a consultant to clinicians, leaders, and professional associations on issues related to nursing and patient safety for almost two decades in Canada, the United States, and internationally. 

Clarke completed his basic clinical and research training in nursing at McGill University, in Montreal, Canada, and pursued a nurse practitioner education and a postdoctoral research fellowship at the University of Pennsylvania. He holds BA and BS degrees from the University of Ottawa and Carleton University, in his hometown of Ottawa, Canada.

PhD - McGill University School of Nursing
MS - McGill University School of Nursing
BA - Carleton University
BS - University of Ottawa

Nursing workforce
Adult health
Nursing administration
Health Policy

Creative Teaching Award, Lawrence S. Bloomberg Faculty of Nursing, University of Toronto (2011)
Dean’s Award for Undergraduate Teaching, University of Pennsylvania School of Nursing (2007)
Junior Faculty Research Award, Biobehavioral and Health Sciences Division School of Nursing, University of Pennsylvania (2006)
Fellow, American Academy of Nursing (2006)
Class of 1965 25th Reunion Term Chair, University of Pennsylvania School of Nursing [for enduring contributions to undergraduate education] (2006)
American Academy of Nursing Media Award for coverage of Aiken, Clarke et al., JAMA, October 23/30, 2002 (2003)
Article of the Year, Academy Health [Academy for Health Services Research and Health Policy] for Aiken, Clarke et al., JAMA, October 23/30, 2002 (2003)
American Academy of Nursing Media Award for coverage of Aiken, Clarke, et al. Health Affairs, 2001 (2002)
Induction into Sigma Theta Tau, Xi Chapter (1999)

Three metaphors and a (mis)quote: Thinking about staffing-outcomes research, health policy and the future of nursing

Clarke, S. P. (2009). Journal of Nursing Management, 17(2), 151-154. 10.1111/j.1365-2834.2009.00991.x
Abstract
Abstract
Conducting research on nurse staffing and outcomes is very challenging, and the application of staffing-outcomes research in practice is both fraught with controversy and vitally important for the safety of our patients and the future of the profession. As I stand back and think about being involved in staffing-outcomes research for nearly a decade and sharing many of my thoughts about this rapidly growing literature in reviews and commentaries in print, certain metaphors for trends in this field come to mind. I won't claim originality for the insights that follow or attempt to thoroughly trace the genealogy of the stories and metaphors here, but offer them to provide what I hope is a fresh perspective to material that I and many of my colleagues have visited and revisited on numerous occasions.

Challenges and Directions for Nursing in the Pay-for-Performance Movement

Clarke, S. P., Raphael, C., & Disch, J. (2008). Policy, Politics, & Nursing Practice, 9(2), 127-134. 10.1177/1527154408320419
Abstract
Abstract
Pay-for-performance (P4P) initiatives attempt to drive quality of care by aligning desired care processes and outcomes with reimbursement. P4P schemes have emerged at a time of great concern about safety and quality in health care and in the face of a growing nurse shortage. This article discusses the state of the literature linking structures for providing nursing care, measures of process heavily favored in P4P initiatives, and patient outcomes and outlines how P4P is expected to affect nursing practice. It also presents directions for managing practice settings to cope with P4P and for steering nursing's involvement in this area of health policy. As implementation broadens, it remains to be seen whether unintended consequences emerge or whether nurses are successful in using the programs and the data sets that result from them to justify investments in nursing services and solidify the profession's position.

Die Studie erweitert Evidenz und Wissen.

Schubert, M., Glass, T. R., Clarke, S. P., Aiken, L. H., Sloane, D. M., Schaffert-Witvliet, B., & De Geest, S. (2008). Krankenpflege. Soins Infirmiers, 101(6), 24-25, 56.

Effects of hospital care environment on patient mortality and nurse outcomes

Aiken, L. H., Clarke, S. P., Sloane, D. M., Lake, E. T., & Cheney, T. (2008). Journal of Nursing Administration, 38(5), 223-229. 10.1097/01.NNA.0000312773.42352.d7
Abstract
Abstract
OBJECTIVE: The objective of this study was to analyze the net effects of nurse practice environments on nurse and patient outcomes after accounting for nurse staffing and education. BACKGROUND: Staffing and education have well-documented associations with patient outcomes, but evidence on the effect of care environments on outcomes has been more limited. METHODS: Data from 10,184 nurses and 232,342 surgical patients in 168 Pennsylvania hospitals were analyzed. Care environments were measured using the practice environment scales of the Nursing Work Index. Outcomes included nurse job satisfaction, burnout, intent to leave, and reports of quality of care, as well as mortality and failure to rescue in patients. RESULTS: Nurses reported more positive job experiences and fewer concerns with care quality, and patients had significantly lower risks of death and failure to rescue in hospitals with better care environments. CONCLUSION: Care environment elements must be optimized alongside nurse staffing and education to achieve high quality of care.

Influencing health policy for the imminent health-care crisis: A task for informed citizens, proactive nurses, and committed researchers

Clarke, S. P., & Gottlieb, L. N. (2008). Canadian Journal of Nursing Research, 40(4), 5-9.

An international hospital outcomes research agenda focused on nursing: Lessons from a decade of collaboration

Clarke, S. P., & Aiken, L. H. (2008). Journal of Clinical Nursing, 17(24), 3317-3323. 10.1111/j.1365-2702.2008.02638.x
Abstract
Abstract
Aims. To describe the origins, design and outcomes of an international hospital outcomes collaboration focused on nursing issues. Background. Across countries with different cultures and histories, nursing and healthcare leaders face similar issues with respect to workforce supply, quality and safety of care and financial constraints. Until researchers began using common research protocols to investigate structure, and outcomes variables in hospital nursing across countries, studying the aspects of work environments most important to patients and nurses in large numbers of hospitals was very difficult, if not impossible. Method. Review/essay. Conclusions. The international collaborations discussed in this article led by the University of Pennsylvania have found remarkable similarities in the experiences of hospital nurses across countries in terms of positive and negative aspects of their work, sizeable differences across hospitals within countries in working conditions and investments in high-quality practice environments, and consistent evidence of connections between modifiable features of nurses' work environments and both patient well-being and factors influencing workforce stability. Relevance to clinical practice. International research collaborations allow benchmarking of countries and facilities within countries on work environment factors that are important to the provision of high quality nursing care. Results of this ongoing research initiative have helped strengthen the case that optimal management of practice environments for nurses in hospitals and other settings are a key strategy for optimising patient outcomes.

The nurse shortage: Where we stand and where we're headed

Clarke, S. P., & Cheung, R. B. (2008). Nursing Management, 39(3), 22-27. 10.1097/01.NUMA.0000313092.89271.98
Abstract
Abstract
Whether it's already touching your facility or its impact is still to come, this crisis will test your skills as a manager. Understanding what's driving the shortage and what's predicted will help you choose the best strategies for addressing its causes and dealing with its consequences.

Nurse staffing and patient outcomes: getting to the heart of the matter in research, practice, and policy.

Clarke, S. P. (2008). The Pennsylvania Nurse, 63(4), 8-9.

Nursing care and patient outcomes: International evidence

Cheung, R. B., Aiken, L. H., Clarke, S. P., & Sloane, D. M. (2008). Enfermeria Clinica, 18(1), 35-40. 10.1016/S1130-8621(08)70691-0
Abstract
Abstract
Countries across the globe are experiencing nursing shortages. In hospitals, supportive practice environments have positive effects on both nurse and patient outcomes. However, these relationships have been established primarily in the US. International studies of the effects of nurse staffing levels and the practice environment on nurse outcomes and the quality of care mirror the findings from the US, thus raising these issues to the international level. The solutions that have been successful in the US for improving the practice environment and patient outcomes are solutions that should be successful in any country, thus putting them on a global scale. The Magnet hospital program is one model that has been shown to improve nurse and patient outcomes and is one solution to the shortage of hospital nurses.

Rationing of nursing care and its relationship to patient outcomes: The Swiss extension of the International Hospital Outcomes Study

Schubert, M., Glass, T. R., Clarke, S. P., Aiken, L. H., Schaffert-Witvliet, B., Sloane, D. M., & De Geest, S. (2008). International Journal for Quality in Health Care, 20(4), 227-237. 10.1093/intqhc/mzn017
Abstract
Abstract
Objectives. To explore the association between implicit rationing of nursing care and selected patient outcomes in Swiss hospitals, adjusting for major organizational variables, including the quality of the nurse practice environment and the level of nurse staffing. Rationing was measured using the newly developed Basel Extent of Rationing of Nursing Care (BERNCA) instrument. Additional data were collected using an adapted version of the International Hospital Outcomes Study questionnaire. Design. Multi-hospital cross-sectional surveys of patients and nurses. Setting. Eight Swiss acute care hospitals Participants. Nurses (1338) and patients (779) on 118 medical, surgical and gynecological units. Main outcome measures. Patient satisfaction, nurse-reported medication errors, patient falls, nosocomial infections, pressure ulcers and critical incidents involving patients over the previous year. Results. Generally, nurses reported rarely having omitted any of the 20 nursing tasks listed in the BERNCA over their last 7 working days. However, despite relatively low levels, implicit rationing of nursing care was a significant predictor of all six patient outcomes studied. Although the adequacy of nursing resources was a significant predictor for most of the patient outcomes in unadjusted models, it was not an independent predictor in the adjusted models. Low nursing resource adequacy ratings were a significant predictor for five of the six patient outcomes in the unadjusted models, but not in the adjusted ones. Conclusion. As a system factor in acute general hospitals, implicit rationing of nursing care is an important new predictor of patient outcomes and merits further study.