By Ali Knight

I recently had the opportunity to attend the American Organization for Nurse Leadership's (AONL) 2026 conference and spend three days in the company of my fellow nursing leaders, including many Advisory Board members.  

As I networked and watched the presentations, I noticed a theme. Like Advisory Board's own research, many sessions focused on how nursing leaders can strengthen financial performance without compromising care. The message was consistent: The path forward is less about working harder or implementing complex solutions and more about intentional staffing, strong leadership, disciplined use of data, and tighter partnerships.

Across sessions, three takeaways stood out to me as critical for nurse executives navigating thin margins and rising workforce complexity.

Takeaway 1: Predictive scheduling can reduce costs and improve staffing

Successful staffing is now determined by how precisely organizations can predict patient needs and deploy their existing workforce to meet them. Rather than using rigid scheduling practices and relying on premium pay, high-performing systems are building models that anticipate variability and tightly align labor to workload.

During the conference, leaders described a shift from staffing averages toward more predictable scheduling. Many organizations are integrating acuity, patient demand, and historical productivity into a single operational view that informs both scheduling and daily staffing decisions.

In practice, this requires nurse leaders to ask different questions: Where are we most vulnerable? When are staff most likely to pick up? How does the posted schedule compare to expected demand? The goal is to improve workload not by adding resources, but by redistributing them to the moments of highest need.

A consistent theme across sessions at AONL was that organizations don't need perfect data to begin, but they need to be willing to make both technical and cultural shifts. Leaders must be willing to redesign long-standing practices and engage the front line in the process.

Flexibility is a key component in scheduling to demand. Consider these resources that outline how flexible work options can achieve balance while benefiting both the organization and the nurse:

• Building a flexible nursing workforce
• The characteristics of a flexible nursing workforce

Takeaway 2: Nurse leaders must close the financial literacy gap

To deliver the staffing and budgeting precision required under today's margin pressures, nurse leaders need stronger financial acumen. Yet many nurses are promoted into leadership roles that include responsibility for budgets and labor management without formal training to match.

Organizations that invested in mandatory, structured financial education reported stronger engagement and more durable productivity gains. The strongest programs focused on helping leaders find, interpret, and apply data, not just review budgets. Just as importantly, the training equipped nurse leaders to tell a clear story about nursing's impact on margin. When nurse leaders use financial data strategically, they expand their influence and better protect the resources required for safe, high-quality care.

These resources provide an overview of health system finances:

• Basics of health system finances, part 1: Expenses
• Basics of health system finances, part 2: Revenue

Takeaway 3: Success isn't siloed

Nursing, finance, and HR cannot operate as adjacent silos if organizations expect to control labor costs and sustain quality. Presenters at the conference shared that their strongest results occurred when these separate functions operated as an integrated team, aligning on shared outcomes, building mutual understanding, and making tradeoffs explicit.

To make this partnership work, recurring check-ins help finance and nurse leaders build shared understanding and trust over time. In these conversations, finance can explain budgets and why numbers change, while nurse leaders can explain what's really happening in the units — like changes in patient needs, flow, and staffing gaps — and how that affects labor. Over time, this partnership will evolve to solving problems collaboratively, with both sides aligned on goals, workforce plans, and what needs to happen day to day.

To build the culture and collaboration required for success, access these resources:

• Enterprise-wide leadership: 2 ways to foster a culture of collaboration and risk-taking
• The 4 questions effective leaders ask during complex times

Final thoughts

None of these takeaways require revolutionary tools to make progress. Instead, they require clarity of purpose, cross-functional partnership, and the discipline to redesign long-standing norms. AONL 2026 reinforced that when nursing leads with precision, credibility, and shared purpose, organizations can strengthen both workforce sustainability and financial performance.

If we didn't get a chance to meet at AONL, I'd love to connect. If you're open to sharing your perspective in a research interview on nursing's role in margin performance, please contact Ali Knight, Director, Nursing and Workforce Research at knighta@advisory.com.