Using the Pareto Principle in 2025

“The most important things don’t always scream the loudest.”  Bob Hawke

Nurse managers are having challenges setting priorities. As one manager explained, We have been told to improve our patient experience scores, but I don’t even know where to start – there are so many things we could do differently. This manager is not alone – knowing where and how to spend your time in leadership is complex, especially in our current environment.

Too often in our nursing leadership work, we have long task lists of goals that we want to accomplish.  When we create these task lists, we can think that everything matters equally, but the truth is that it doesn’t. Some activities yield a far greater return on our time than others.

This is where the Pareto Principle becomes essential – the 80/20 law of the vital few.  This principle has research support. Using your efforts at work as an example, the law proposes that a minority (20%) of actions, inputs, and efforts lead to a majority of results, outputs, or rewards.  Another aspect of the law relevant to leadership is that you spend 80% of your time dealing with issues from 20% of the staff. In other words, small efforts in the right areas can lead to the most significant rewards. 80% of what you spend your time on has little impact. Knowing the difference can change how you lead.

I have talked with nurse leaders about the activities they engage in that have the most significant payback for them.  The following are some of the answers that they have given me:

• Round more consistently and ask patients and families about their experiences
• Come in and talk with my night staff
• Watch the communication my staff is (or maybe isn’t) having with patients and families
• Learn more about my staff on a personal level
• Do STAY interviews
• Limit my meeting attendance to one a day
• Spend more time coaching my staff
• Develop my charge nurse’s leadership skills
• Become more approachable
• Talk less and listen more
• Learn budgeting
• Return for my Master’s degree
• Become more proficient with technology
• Set better boundaries and leave the unit by 5 PM

The research suggests that leaders are usually pretty accurate when they list the 20% of activities that yield the most results. People instinctively know what matters most, even if they don’t regularly focus on them.  It is taking the next step that becomes important, which means going small for the fewer things that will have the most effect.

© emergingrnleader.com 2025

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