Abstract: Objective: To capture ward head nurses' operational management experience under the Diagnosis-Related Groups (DRG) payment system in order to provide decision-making references for ward head nurses to enhance the precision management of nursing quality and cost control capabilities. Methods: The constructivist paradigm was followed and a descriptive phenomenological research design was used. A total of 12 head nurses were recruited through purposive sampling from five tertiary grade A hospitals in Zhejiang province. Semi-structured interviews were conducted from February to April 2025 and data were analyzed using Colaizzi's seven-step method. Results: Three themes were extracted: the expansion of the head nurses' job roles, the growth in operational management practice, and the eagerness for digital-intelligent management capabilities under the DRG payment system. Conclusion: The DRG payment system has reshaped the connotation of head nurses' roles, requiring them to uphold the principle of prioritizing quality and achieve dynamic balance between cost and quality through multidimensional initiatives to improving the operational management level of medical institutions.

Key words: Diagnosis-Related Groups; operational management experience; qualitative research; head nurse