{"id":{"repo_id":"usfca","oai_identifier":"oai:repository.usfca.edu:dnp-1029"},"canonical_url":"https://search.dev.ndltd.org/etd/usfca/oai:repository.usfca.edu:dnp-1029","repository":{"repo_id":"usfca","name":"University of San Francisco","base_url":"https://repository.usfca.edu/do/oai/"},"display":{"title":"Improving Value Based Purchasing Through the Implementation of the Clinical Nurse Leader Role: The Chief Nursing Officer’s Case for Change","abstract":"<p>The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical Nurse Leader. This Master’s prepared advanced generalist has been educated in healthcare reform and its impact on patient safety, quality, and the organization’s financial condition. An evidence-based business case will demonstrate the outcomes and a return on investment for the Clinical Nurse Leader role. The Chief Nursing Officer can employ transformational leadership skills to articulate the need and benefit of such a role, and influence an organization to invest in this valuable intervention.</p> <p><em>Keywords: </em>Chief Nursing Officer, CNO, Clinical Nurse Leader, CNL, Value Based Purchasing, VBP, education, quality, pay for performance, evidenced-based practice.</p>","abstract_html":"&lt;p&gt;The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical Nurse Leader. This Master’s prepared advanced generalist has been educated in healthcare reform and its impact on patient safety, quality, and the organization’s financial condition. An evidence-based business case will demonstrate the outcomes and a return on investment for the Clinical Nurse Leader role. The Chief Nursing Officer can employ transformational leadership skills to articulate the need and benefit of such a role, and influence an organization to invest in this valuable intervention.&lt;/p&gt; &lt;p&gt;&lt;em&gt;Keywords: &lt;/em&gt;Chief Nursing Officer, CNO, Clinical Nurse Leader, CNL, Value Based Purchasing, VBP, education, quality, pay for performance, evidenced-based practice.&lt;/p&gt;","abstract_has_math":false,"creators":["Hunstock, Leanne M"],"institution":null,"degree_name":"Doctor of Nursing Practice (DNP)","degree_level":"Project","degree_discipline":"Nursing","degree_department":null,"school":null,"contributors":["Dr. KT Waxman","Dr. Marjorie Barter"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2013,"date_issued":"2013-12-13T08:00:00Z","date_published":"2013-12-13T08:00:00Z","updated_at":"2026-07-24T05:42:43Z","subjects":["CNL","VBP","CNO","Clinical Nurse Leader","Quality improvement","Nursing Administration"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"https://repository.usfca.edu/dnp/21","outbound_label":"Repository record","outbound_source":"dc:identifier"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Dr. KT Waxman","Dr. Marjorie Barter"]},{"key":"dc:creator","label":"Author","values":["Hunstock, Leanne M"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.available","label":"Dc Date Available","values":["2013-12-17T08:00:00Z"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Nursing"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Project"]},{"key":"thesis:degree_name","label":"Degree Name","values":["Doctor of Nursing Practice (DNP)"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["CNL","VBP","CNO","Clinical Nurse Leader","Quality improvement","Nursing Administration"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://repository.usfca.edu/dnp/21"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["<p>The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical Nurse Leader. This Master’s prepared advanced generalist has been educated in healthcare reform and its impact on patient safety, quality, and the organization’s financial condition. An evidence-based business case will demonstrate the outcomes and a return on investment for the Clinical Nurse Leader role. The Chief Nursing Officer can employ transformational leadership skills to articulate the need and benefit of such a role, and influence an organization to invest in this valuable intervention.</p> <p><em>Keywords: </em>Chief Nursing Officer, CNO, Clinical Nurse Leader, CNL, Value Based Purchasing, VBP, education, quality, pay for performance, evidenced-based practice.</p>"]},{"key":"dc:title","label":"Title","values":["Improving Value Based Purchasing Through the Implementation of the Clinical Nurse Leader Role: The Chief Nursing Officer’s Case for Change"]}]}],"canonical_facts":{"dc:contributor":["Dr. KT Waxman","Dr. Marjorie Barter"],"dc:creator":["Hunstock, Leanne M"],"dc:date.available":["2013-12-17T08:00:00Z"],"dc:description.abstract":["<p>The healthcare industry is focused on the implementation of the Affordable Care Act, the payment reform package from Centers for Medicare and Medicaid Services and the development of Accountable Care Organizations. The decisions, behaviors, and practices of medical and clinical staff directly impact patient care, quality, and subsequently cost and reimbursement. The imperative to balance quality and patient safety with cost effectiveness requires a complex orchestration of all the elements of care within the clinical microsystem. A priority is to support and enable bedside nurses’ daily practice, priorities, and decision-making. This can be accomplished through the implementation of the Clinical Nurse Leader. This Master’s prepared advanced generalist has been educated in healthcare reform and its impact on patient safety, quality, and the organization’s financial condition. An evidence-based business case will demonstrate the outcomes and a return on investment for the Clinical Nurse Leader role. The Chief Nursing Officer can employ transformational leadership skills to articulate the need and benefit of such a role, and influence an organization to invest in this valuable intervention.</p> <p><em>Keywords: </em>Chief Nursing Officer, CNO, Clinical Nurse Leader, CNL, Value Based Purchasing, VBP, education, quality, pay for performance, evidenced-based practice.</p>"],"dc:identifier":["https://repository.usfca.edu/dnp/21"],"dc:subject":["CNL","VBP","CNO","Clinical Nurse Leader","Quality improvement","Nursing Administration"],"dc:title":["Improving Value Based Purchasing Through the Implementation of the Clinical Nurse Leader Role: The Chief Nursing Officer’s Case for Change"],"thesis:degree_discipline":["Nursing"],"thesis:degree_level":["Project"],"thesis:degree_name":["Doctor of Nursing Practice (DNP)"]},"updated_at":"2026-07-24T05:42:43Z"}