Sean Clarke

Faculty

Sean Clarke Headshot

Sean Clarke

FAAN PhD RN

Ursula Springer Professor in Nursing Leadership

1 212 998 5264

433 First Ave
New York, NY 10010
United States

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)

Nursing workforce: A special issue

Rafferty, A. M., & Clarke, S. P. (2009). International Journal of Nursing Studies, 46(7), 875-878. 10.1016/j.ijnurstu.2009.04.012

Organizational traits, care processes, and burnout among chronic hemodialysis nurses

Flynn, L., Thomas-Hawkins, C., & Clarke, S. P. (2009). Western Journal of Nursing Research, 31(5), 569-582. 10.1177/0193945909331430
Abstract
Abstract
In light of evidence linking registered nurse (RN) staffing levels to patient outcomes in chronic hemodialysis facilities, U.S. government regulations have set minimum RN staffing requirements during dialysis. Consequently, facility administrators are focused on decreasing nurse attrition in this crucial practice setting. This study used a cross-sectional, correlational design to investigate the effects of workload, practice environment, and care processes on burnout among nurses in U.S. chronic hemodialysis centers and to determine the association between burnout and nurses' intentions to leave their jobs. Findings indicate that predictors were associated with an increased likelihood of nurse burnout and that nurses experiencing burnout were more likely to be planning to leave their jobs. Findings have important implications for retention of nurses, enhancement of patient safety, and adherence to new federal staffing requirements in chronic hemodialysis units.

Practice environments and their associations with nurse-reported outcomes in Belgian hospitals: Development and preliminary validation of a Dutch adaptation of the Revised Nursing Work Index

Van Bogaert, P., Clarke, S., Vermeyen, K., Meulemans, H., & Van De Heyning, P. (2009). International Journal of Nursing Studies, 46(1), 55-65. 10.1016/j.ijnurstu.2008.07.009
Abstract
Abstract
Aim: To study the relationship between nurse work environment, job outcomes and nurse-assessed quality of care in the Belgian context. Background: Work environment characteristics are important for attracting and retaining professional nurses in hospitals. The Revised Nursing Work Index (NWI-R) was originally designed to describe the professional nurse work environment in U.S. Magnet Hospitals and subsequently has been extensively used in research internationally. Method: The NWI-R was translated into Dutch to measure the nurse work environment in 155 nurses across 13 units in three Belgian hospitals. Factor analysis was used to identify a set of coherent subscales. The relationship between work environments and job outcomes and nurse-assessed quality of care was investigated using logistic and linear regression analyses. Results: Three reliable, consistent and meaningful subscales of the NWI-R were identified: nurse-physician relations, nurse management at the unit level and hospital management and organizational support. All three subscales had significant associations with several outcome variables. Nurse-physician relations had a significant positive association with nurse job satisfaction, intention to stay the hospital, the nurse-assessed unit level quality of care and personal accomplishment. Nurse management at the unit level had a significant positive association with the nurse job satisfaction, nurse-assessed quality of care on the unit and in the hospital, and personal accomplishment. Hospital management and organizational support had a significant positive association with the nurse-assessed quality of care in the hospital and personal accomplishment. Higher ratings of nurse-physician relations and nurse management at the unit level had significant negative associations with both the Maslach Burnout Inventory emotional exhaustion and depersonalization dimensions, whereas hospital management and organizational support was inversely associated only with depersonalization scores. Conclusion: A Dutch version of the NWI-R questionnaire produced comparable subscales to those found by many other researchers internationally. The resulting measures of the professional practice environment in Belgian hospitals showed expected relationships with nurse self-reports of job outcomes and perceptions of hospital quality.

The relationship between inpatient cardiac surgery mortality and nurse numbers and educational level: Analysis of administrative data

Van Den Heede, K., Lesaffre, E., Diya, L., Vleugels, A., Clarke, S. P., Aiken, L. H., & Sermeus, W. (2009). International Journal of Nursing Studies, 46(6), 796-803. 10.1016/j.ijnurstu.2008.12.018
Abstract
Abstract
Background: In most multicenter studies that examine the relationship between nurse staffing and patient safety, nurse-staffing levels are measured per hospital. This can obscure relationships between staffing and outcomes at the unit level and lead to invalid inferences. Objective: In the present study, we examined the association between nurse-staffing levels in nursing units that treat postoperative cardiac surgery patients and the in-hospital mortality of these patients. Design-setting-participants: We illustrated our approach by using administrative databases (Year 2003) representing all Belgian cardiac centers (n = 28), which included data from 58 intensive care and 75 general nursing units and 9054 patients. Methods: We used multilevel logistic regression models and controlled for differences in patient characteristics, nursing care intensity, and cardiac procedural volume. Results: Increased nurse staffing in postoperative general nursing units was significantly associated with decreased mortality. Nurse staffing in postoperative intensive care units was not significantly associated with in-hospital mortality possibly due to lack of variation in ICU staffing across hospitals. Conclusion: This study, together with the international body of evidence, suggests that nurse staffing is one of several variables influencing patient safety. These findings further suggest the need to study the impact of nurse-staffing levels on in-hospital mortality using nursing-unit-level specific data.

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.