UC Irvine

It has become a national priority to have an effective care delivery system for the 21st century. Improving the quality of care and ensuring that the care delivered in a patient-centered framework are goals for many organizations. Nursing practice will be at the core of these changes, working at the point of service as well as at the organizational level. In response to the need for nursing to realign our practices in accordance with the new healthcare mandate, the American Association of Colleges of Nursing has developed the clinical nurse leader (CNL) role. The CNL is a master’s-prepared RN educated to enhance the efficiency of care delivery and facilitate the coordination of care at the bedside through effective collaboration with all healthcare providers. Clinical nurse leader competencies align with key messages highlighted in the Institute of Medicine’s 2010 report on The Future of Nursing, including the need for a highly educated nursing workforce practicing at their full scope, and for RNs to become full partners with physicians and other health professionals in redesigning healthcare. The CNL role has been demonstrated to improve patient outcomes, but it has not been widely adopted throughout the country. This article describes how a progressive care unit (PCU) redesigned its care delivery system to implement the CNL role, using Kotter’s Eight Change Phases model as a guide.