The CNO: Challenges and Opportunities on the Journey to ExcellenceTagnesi, Kathryn MA, BSN, RN, NEA-BC; Dumont, Cheryl PhD, MSN, RN; Rawlinson, Cynthia BA, BS; Byrd, Harry IIINursing Administration Quarterly: April-June 2009 - Volume 33 - Issue 2 - p 159–167 doi: 10.1097/NAQ.0b013e3181a10d7f Article Abstract Author Information Moving a southern rural community medical center through the multitude of regulatory, fiscal, social, cultural, and political changes required for healthcare excellence in the early 21st century has provided some particularly unique challenges. This article describes opportunities and initiatives taken by a chief nursing officer and key members of the healthcare team to meet the challenges of moving a rural and rapidly growing healthcare system toward excellence. The initiatives and perspectives of the team, the chief nursing officer, performance improvement/quality corporate director, the board chairman, and nursing leaders, are presented. From the Winchester Medical Center, Winchester, Virgina (Ms Tagnesi, Dr Dumont, and Mr Byrd); and Valley Health, Winchester, VA (Ms Rawlinson). Corresponding author: Kathryn Tagnesi, MA, BSN, RN, NEA-BC, 1840 Amherst St, Winchester, VA 22601 (e-mail: firstname.lastname@example.org). © 2009 Lippincott Williams & Wilkins, Inc.