System Chief Nurse Executive White Paper

As the U.S. health care environment continues to evolve in response to calls for lower cost, higher quality and an improved patient experience, health care organizations are undergoing fundamental change. This in turn requires the system Chief Nurse Executive (CNE) to adjust and embrace new competencies.

These include improving population health, increasing quality, expanding provider coverage and managing increasingly complex health information technology systems. System nursing leaders must take on these issues while at the same time ensuring safety across the continuum of care and keeping financial viability in mind. The system CNE must also remain prepared to respond to evolving changes in ownership or partnership of their health care organization.


AONL has responded to the changing role of nurse executives by providing research and strategic thinking. The organization recognized the need to provide insight into the role of system CNEs in helping to lead the transition of the U.S. health care system from a focus on acute care to the entire continuum of care.

The contributors to this white paper reviewed literature predicting future changes in the health care system and identified three areas of competency that will be particularly important for system CNEs to obtain and maintain:

  1. Supporting the health care system’s ongoing transition from acute care to continuum of care
  2. Participating in an interdisciplinary team approach through shared leadership
  3. Enlarging the role of the advanced practice registered nurse (APRN) in relation to the integration and synthesis of clinical services