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)

Concepts

Van Bogaert, P., & Clarke, S. (2018). In The Organizational Context of Nursing Practice: Organization of nursing work and the psychosocial experience of nurses (1–, pp. 5-47). Springer International Publishing. 10.1007/978-3-319-71042-6_2
Abstract
Abstract
In this chapter, the intuitive link between balanced, healthy, and supportive psychosocial work environments and a variety of vitally important patient, nurse, and organizational outcomes is discussed with reference to a number of clearly defined and well-researched concepts. Among the essential concepts that ground the rest of the book is the notion of a bundle of factors that provide a context for nurses' work and are known collectively as the practice environment. Landmark studies that focused specifically on nurses' experiences of their work environments in exemplary hospitals examined so-called Magnet hospitals, leading to a framework that describes the practice environment and its linkage with professional well-being, occupational stress, and quality of practice and productivity. Many ideas and models have obvious connections to the notion of practice environment such as Job Demand- Control-Support model, worklife dimensions and burnout, concepts related to burnout such as compassion fatigue, and work engagement as a mirror image concept of burnout, as well as notions of empowerment and authentic leadership. These concepts have been chosen for discussion here based on critical masses of evidence pointing to their usefulness in healthcare management and specifically in the management of nursing services. Together all of these concepts and supporting research and scholarship speak to a common point: intentional leadership approaches, grounded in a comprehensive understanding of nurses' psychosocial experiences of their work, are essential to nurses' abilities to respond to complex patients' needs in rapidly changing healthcare contexts and socioeconomic conditions.

Effect of transformational leadership on job satisfaction and patient safety outcomes

Boamah, S. A., Spence Laschinger, H. K., Wong, C., & Clarke, S. (2018). Nursing Outlook, 66(2), 180-189. 10.1016/j.outlook.2017.10.004
Abstract
Abstract
Background: Improving patient safety within health care organizations requires effective leadership at all levels. Purpose: The objective of this study was to investigate the effects of nurse managers’ transformational leadership behaviors on job satisfaction and patient safety outcomes. Methods: A random sample of acute care nurses in Ontario (N = 378) completed the crosssectional survey. Hypothesized model was tested using structural equation modeling. Finding: The model fit the data acceptably. Transformational leadership had a strong positive influence on workplace empowerment, which in turn increased nurses’ job satisfaction and decreased the frequency of adverse patient outcomes. Subsequently, job satisfaction was related to lower adverse events. Conclusion: The findings provide support for managers’ use of transformational leadership behaviors as a useful strategy in creating workplace conditions that promote better safety outcomes for patients and nurses.

Future steps in practice and research

Van Bogaert, P., & Clarke, S. (2018). In The Organizational Context of Nursing Practice (1–, pp. 297-307). Springer International Publishing. 10.1007/978-3-319-71042-6_14
Abstract
Abstract
The concepts at the heart of this book originated more than 35 years ago and stemmed from repeated observations of a single troublesome phenomenon: cyclical nurse shortages in hospitals. Inquiries to deal with nurse workforce problems occurred alongside growing research findings suggesting that clinical nurses and other professionals were at risk of mutating from enthusiastic workers engaged with their clients to becoming emotionally drained, cynical, and insecure-the phenomenon known as burnout. The journey of this research field-reflected in the progression of the chapters in this book-has led to a variety of studies attempting to address both phenomena by focusing on the organizational contexts of nursing practice. Each of the chapters in this book offers findings and insights that we have synthesized into four recommendations for future steps in practice and another four recommendations for future steps in research. Connecting all of these recommendations is an emphasis on continuous improvement and change processes embedded in the organizational context of nursing practice, the need to draw on relevant empirical research, and the imperative for research and practice in this field to guide and inspire each other.

General conclusions

Van Bogaert, P., & Clarke, S. (2018). In The Organizational Context of Nursing Practice (1–, pp. 309-310). Springer International Publishing. 10.1007/978-3-319-71042-6_15

In Response:

Edmonds, J. K., O’Hara, M., Clarke, S. P., & Shah, N. T. (2018, March 1). In JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing (Vols. 47, Issues 2, pp. 234-235). 10.1016/j.jogn.2018.02.001

The organizational context of nursing practice: Concepts, evidence, and interventions for improvement

Van Bogaert, P., & Clarke, S. (2018). (1–). Springer International Publishing. 10.1007/978-3-319-71042-6
Abstract
Abstract
This book explores the various features of work environments that affect nurses' experiences of their work, their interactions with co-workers and patients, and ultimately health care quality and patient outcomes. Using a broad and comprehensive approach, the authors identify the most extensively researched and best-understood concepts in the field and presents a critical and up-to-date review of the evidence regarding causes and effects of work environment features. It then presents evidence regarding organizational interventions aimed at broad ranges of clinical practices and outcomes, such as team-based interventions and management practices to improve practice climate. The ideas, approaches, and evidence are presented by a team of researchers and experienced practitioner/leaders; taken together, they form a state-of-the-science toolkit. Unique features of this book include a systematic presentation of best practices in nursing and healthcare leadership, along with the conceptual grounding and empirical support for these approaches, and extensive demonstrations of how these practices, many of which originated in North America, apply to European contexts.

Organizational predictors and determinants of nurses' reported outcomes

Van Bogaert, P., & Clarke, S. (2018). In The Organizational Context of Nursing Practice: Evidence from a 10-year program of research (1–, pp. 49-100). Springer International Publishing. 10.1007/978-3-319-71042-6_3
Abstract
Abstract
A 10-year research program systematically examined organizational features of nurses' workplaces in relation to nurse and patient outcomes. Its major results have been published in peer-reviewed international journals and presented here with replicated analyses and largely new datasets. First, a set of measures of nurse practice environment features and nurse work characteristics such as workload, decision latitude, and social capital along with burnout and work engagement as well as nurses' self-assessed job outcomes and quality of care was developed. These were examined in various populations of nurses such as those working in acute care hospitals and in long-term facilities. Secondly, models to explain associations between these selected variables were developed and tested in samples of acute hospital nurses. Thirdly, multilevel analyses of the associations between these variables confirmed that the phenomenon of organizational influences on work experiences occurred not only at the individual level but also at the team level in various study populations and across healthcare domains. Next, a longitudinal study design was set up to investigate the impact of planned transformations in the hospital organization as well as the implementation of the Productive Ward-Releasing Time to Care program aimed at strengthening practice environments and outcomes in a university hospital. Finally, a phenomenological study was undertaken to examine staff nurse and nurse manager perceptions and experiences of structural empowerment and the extent to which structural empowerment supports high-quality patient care. In addition, an explanatory sequential mixed methods design blended qualitative study results regarding staff nurses' experiences and perceptions of workload with prior quantitative results regarding structural empowerment to explain and interpret the findings of both models.

Quality of Primary Care Provided to Medicare Beneficiaries by Nurse Practitioners and Physicians

Buerhaus, P., Perloff, J., Clarke, S., O’Reilly-Jacob, M., Zolotusky, G., & DesRoches, C. M. (2018). Medical Care, 56(6), 484-490. 10.1097/MLR.0000000000000908
Abstract
Abstract
Objective: To examine differences in the quality of care provided by primary care nurse practitioners (PCNPs), primary care physicians (PCMDs), or both clinicians. Data Sources: Medicare part A and part B claims during 2012-2013. Study Design: Retrospective cohort design using standard risk-Adjustment methodologies and propensity score weighting assessing 16 claims-based quality measures grouped into 4 domains of primary care: chronic disease management, preventable hospitalizations, adverse outcomes, and cancer screening. Extraction Methods: Continuously enrolled aged, disabled, and dual eligible beneficiaries who received at least 25% of their primary care services from a random sample of PCMDs, PCNPs, or both clinicians. Principal Findings: Beneficiaries attributed to PCNPs had lower hospital admissions, readmissions, inappropriate emergency department use, and low-value imaging for low back pain. Beneficiaries attributed to PCMDs were more likely than those attributed to PCNPs to receive chronic disease management and cancer screenings. Quality of care for beneficiaries jointly attributed to both clinicians generally scored in the middle of the PCNP and PCMD attributed beneficiaries with the exception of cancer screening. Conclusions: The quality of primary care varies by clinician type, with different strengths for PCNPs and PCMDs. These comparative advantages should be considered when determining how to organize primary care to Medicare beneficiaries.

Scope of Nursing Practice in a Tertiary Pediatric Setting: Associations With Nurse and Job Characteristics and Job Satisfaction

Déry, J., Clarke, S. P., D’Amour, D., & Blais, R. (2018). Journal of Nursing Scholarship, 50(1), 56-64. 10.1111/jnu.12352
Abstract
Abstract
Purpose: While professional nursing, like other health professions, has a recognized educational base and a legal scope of practice that is remarkably consistent across societies, there are important variations even within the same institution or organization in the extent to which professional nurses engage in the full range of activities for which they are qualified. There has been limited study of enacted (actual) scope of nursing practice (ESOP) or of its impacts on nurse job outcomes, such as job satisfaction. The aim of this study is to measure ESOP, as well as its predictors and impact on job satisfaction, in a specialty university-affiliated tertiary referral center in one of the few remaining jurisdictions outside the United States that continue to educate registered nurses at multiple educational levels. Methods: This was a correlational cross-sectional design using structural equation modeling. Self-administered questionnaires were completed by 301 registered nurses holding permanent positions in specific clinical areas for 6 months or longer in a pediatric hospital in the province of Quebec, Canada. Findings: ESOP or actual scope of practice was low—on average, nurses applied the range of skills within their theoretical scopes of practice only occasionally or “less than frequently” in their daily work (3.21 out of a possible 6 points). ESOP was strongly related to decision latitude (β = 0.319; p =.012), role ambiguity (β = 0.297; p =.011), and role overload (β = 0.201; p =.012). The personal characteristics that exerted the greatest direct influence on ESOP were education level (β = 0.128; p =.015) and growth need strength (β = 0.151; p =.008). Results also showed that ESOP exerts a direct positive influence on nurses’ job satisfaction (β = 0.118; p =.006). Structural equation modeling analyses revealed a good fit of the data to the hypothesized conceptual model (χ²/df ratio index = 1.68, root mean square error of approximation = 0.049, confirmatory fit index = 0.985). Conclusions: Specific aspects of nurses’ jobs are closely related to ESOP. ESOP is limited by certain job and personal characteristics and appears to affect nurses’ job satisfaction. Clinical Relevance: Results suggest that ESOP might be improved by adjusting nursing job characteristics and practice environments and that expanding ESOP increases nurse job satisfaction and may improve other health system outcomes as well.

The BSN entry into practice debate

Clarke, S. P. (2017). Nursing Made Incredibly Easy, 15(1), 6-8. 10.1097/01.NME.0000508544.59940.19