Abstract
In 2004, a 551-bed nonprofit hospital launched a pilot of the unit-based clinical nurse leader (CNL) role to support staff nurses and their patients. Thus far, the role has demonstrated great promise in promoting individual patient-centered outcomes, although the pilot has identified potential adaptations to enhance aggregate outcomes. These include decreasing the patient-to-CNL ratio, increasing CNL availability to 7 days a week, and reconsidering whether to fill CNL positions with nurses who were prepared as nurse practitioners.