Abstract
Chief Nurse Executives (CNEs) are increasingly providing leadership in integrated health care systems or organized delivery systems (ODSs). An ODS provides coordinated care services to populations to which nursing is held clinically and fiscally accountable for health status and outcomes. This descriptive study uses an innovative approach, Appreciative Inquiry (AI), to examine performance competencies that nurses expect of a CNE in an ODS. These are different from competencies expected in a single organization, but have yet to be identified and described. Results suggest that while expectations may vary among an ODS's entities, it is possible to co-create CNE trust and performance competencies for the new organizational structure.