Abstract
A quality improvement process was implemented within a large, tertiary healthcare organization to develop and implement a roundtable culture as part of a fatigue risk management system focused on mitigating nurse leader fatigue and stress. Strategies to form trusting collaboration and reduce leader attrition were initiated and assessed for effectiveness. Results show measurable decreases in reported levels of stress and attrition. Acute, chronic, and persistent fatigue continue to challenge those in leadership roles.