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Nurses across the system wanted to have their roles better defined and to be more empowered so as to deliver better care. In 2009, the head of the Nursing Institute, Executive Chief Nursing Officer (ECNO) Sarah Sinclair, established a system-wide organization with four Associate Chief Nursing Officers (ACNOs), respectively responsible for Clinical Practice and Research; Informatics; Clinical Education and Professional Development; and Care Management and Social Work. The organization also includes a Human Resource Business Partner and System Executive/Director of Nursing Operations Integration, both of whom reported to the ECNO. Finally, the chief nursing officers for each of the 11 hospitals report directly to the ECNO. With this structure in place, efforts commenced to standardize nursing across the system.