Abstract
Seton Nursing reengineered previous models of care and leadership to accommodate rapid growth of its health care system from individual acute care sites to a health care system with consistent quality and standardization of like units across the system. Shared governance promotes collaboration with shared decision making and accountability; however, the role and methods of a system chief nursing officer to connect shared governance across a new system has not been previously described. A system chief nursing officer can significantly influence and guide the nursing strategic direction at all the health care system-related facilities by utilizing a single, systemwide nursing shared governance structure. Using this structure provides a venue to maximize the influence of a transformational leader and creates efficiencies in workforce development, resource management, best practice identification, and spread of initiatives and improvements to adapt to an ever-changing health care landscape. This is the story of one such system chief nursing officer.