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As healthcare leaders search for viable options to cut costs, increase efficiencies, and improve the product that they offer to customers, many are looking at different business models to adopt. At the same time, an aging workforce of nurses feel the pressure of being overworked and understaffed, resulting in both decreased job and patient satisfaction. Virginia Mason Medical Center in Seattle, Wash, has implemented the Virginia Mason Production System, using proven concepts adapted from the Toyota Production System that effectively eliminate \"muda\" or waste, in workplace processes. The authors discuss the application of the Virginia Mason Production System and how it has resulted in increased time for nurses to care for their patients.

More than 90 members of the American Association of Colleges of Nursing and 190 practice sites have partnered to develop the clinical nurse leader (CNL) role. The partnership has created synergy between education and practice and nurtured innovation and diffusion of learning on a national basis. In this ongoing department, the editor, Jolene Tornabeni, MA, RN, FAAN, FACHE, showcases a variety of nurse leaders who discuss their new patient care delivery models in preparation for the CNL role and CNLs who highlight partnerships with their clinical colleagues to improve patient care. In this article, the authors discuss the needs for changes in the nursing care delivery model, the implementation of the role of the CNL using the tools of the Virginia Mason Production System, as well as early outcomes and future opportunities for the expansion of the CNL role.