The system chief nurse executive role: sign of the changing times?

As the health care system landscape continues to evolve toward more integrated care, a trend toward consolidation of hospitals into larger systems continues. The systems are more than the traditional hospital-centric structures, as acute care becomes just one component to a larger system that includes ambulatory care, acute and post-acute care, chronic disease and end-of-life management, and all structures in between. To provide leadership in these new models, there have been an increasing number of system chief nurse executives hired both to facilitate the integration of care and to align and standardize nursing practice across the continuum. By definition, the role of the system chief nurse executive differs from that of the entity chief nursing officer. A crosswalk is presented that describes the differences between the roles and reflects on the implication for system chief nurse executives during our changing times.