• changing roles;
  • clinical nurse leader;
  • evidence-based practice;
  • interdisciplinary team leadership;
  • outcomes


This study describes the evolution of the clinical nurse leader (CNL®) role and its utility in a tertiary care and community hospital.


In the US, quality and safety metrics are being publically reported and healthcare organizations are just beginning to experience pay-for-performance and its impact. The American Association of the Colleges of Nursing (AACN) developed the role of the CNL to address the complexities and challenges of providing high-quality care in the current environment.


Since 2007, a cohort of CNLs in practice has evaluated the effectiveness of the role with measures of clinical outcomes, financial savings and case studies.

Key issues

Having CNLs with a strategic perspective acting as facilitators and integrators of care has proven invaluable. Leadership support has been critical and commitment to maintaining the integrity of the role has ensured its success and sustainability.


This role has established its value in risk assessment, strategic quality improvement, interdisciplinary collaboration and the implementation of evidence-based solutions.

Implications for nursing management

The flexibility and broad scope of this role allows for its use across practice settings and represents an exciting opportunity for nursing to drive quality of care to new levels while managing costs.