Clinical Nurse Leader (CNL)
The Clinical Nurse Leader (CNL) role is designed to deliver clinical leadership in all health care settings and to respond to individuals and families within a micro-system of care. As of August 2007, over 80 VA Medical Centers (VAMC) sites have requested to participate in the CNL Initiative. The CNL is expected to address and improve the following:
This initiative is targeted towards RNs with a Master’s Degree in Nursing who desire to stay in the direct care setting but practice in an advanced generalist role with a broad scope of practice and more complex level of responsibility for a specific patient care unit.
The Clinical Nurse Leader Spread Plan Initiative
In the summer of 2011, ONS set a strategic goal of implementing a CNL at all points of care throughout the VHA system by fiscal year 2016. The CNL spread plan was developed to achieve this strategic goal, comprised of a portfolio of multi-year activities spanning from fiscal year 2011 through 2016.
The CNL Spread Plan Objectives:
Key Initiatives in the CNL Spread Plan
Systems Redesign Academy for the Improvement of Microsystems
A team of CNLs which represented VA New Jersey Health Care System for the first AIM learning session cohort in Alexandria, VA in September 2011
In collaboration with the Mid-West Mountain VA Engineering Resource Center (VERC), ONS has developed an Academy for the Improvement of Microsystems (AIM) to foster the development of the CNL role through an inter-professional approach, emphasizing systems redesign and flow improvement.
The focus of the AIM is collaborative learning sessions which all VAMCs will participate in throughout the implementation of the spread plan. The VERC have developed a curriculum which includes one face to face meeting and a subsequent virtual collaborative which will guide facilities in implementing and readying the environment for setting up CNL programs, as well as equipping participants in Lean yellow belt, analytics, systems redesign, change management, and leadership development training.
ONS plans to coordinate one cohort of CNLs each year until fiscal year 2016 to undergo the Healthcare Analytics Certificate Program, held by the VA Nebraska-Western Iowa HCS and University of Nebraska–Lincoln. The goal of developing CNL analytics course cohorts is to emphasize teamwork and utilize analytics-driven decisions for value, quality, access, and satisfaction. The first cohort of CNLs to participate in the certificate program was launched on Feb 29th, 2012.
CNL Implementation & Evaluation Service
The CNL Implementation & Evaluation service provides one-on-one consultation and assistance to VA Medical Centers, academic affiliates offering a CNL curriculum, and individual CNL students and preceptors. Specific offerings include guidance on:
For more information, please see the CNL brochure (pdf)
Marjory Williams, PhD, RN,
Alice Avolio, MS, RN
(503) 220-8262 ext 56133
CNL Transition to Practice Program
A six month transition-to-practice program is under development to enhance CNL knowledge, skills, and abilities in domains aligned with the CNL academic curriculum. This transition-to-practice program uses facilitation and mentoring by a facility-based preceptor, residency coordinator/director, and optional academic affiliate advisor or CNL mentor during the guided experience. The program will enhance CNL knowledge, skills and abilities in coordinating care, applying evidence-based practices, delivering care in professional nursing practice, improving processes, demonstrating transformational leadership and translating informatics and analytics data to practice.
ResourcesCNL Spread Plan Timeline (pdf)