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  1. Spicer, Joan Gygax PhD, RN, CCM, NEA-BC
  2. Sparacino, Patricia S.A. PhD, RN, FAAN
  3. Larkin, Noris E. BSN, RN


Clinical and administrative nurse leaders in a safety-net health system in Northern California developed and implemented a nursing practice framework to complement the system's 5-year strategic initiative (2015-2020). Their contributions have been integral to the health system's strategic direction and success. This article summarizes highlights of the journey from intellectual curiosity to pragmatic implementation system-wide.