AACN CSI Academy

The American Association of Critical Care Nurses (AACN) Clinical Scene Investigator (CSI) Academy


Background & Goal

Traditionally, quality improvement projects are generated and diffused in a top-down approach and may or may not include staff nurses in the design of these programs, yet staff nurses are held accountable for the implementation and outcomes.  

The American Association of Critical Care Nurses (AACN) Clinical Scene Investigator (CSI) Academy (“AACN CSI Academy”) leverages staff nurses’ expertise to improve outcomes quality work by teaching staff nurses new skills in leadership, project management, and quality improvement methods.  The program empowers and shepherds hospital-based staff nurses to lead an interdisciplinary team in the life-cycle of substantive quality initiatives that measurably improve patient outcomes and hospitals’ financials.

The curriculum and project outputs directly address three of the seven Institute of Medicine’s recommendations in the Future of Nursing Report: Recommendation 2-Expand opportunities for nurses to lead and diffuse collaborative improvement efforts; Recommendation 6-Ensure that nurses engage in lifelong learning; and Recommendation 7-Prepare and enable nurses to lead change to advance health. Similarly, the program advances the Institute for Healthcare Improvement’s Triple Aim by: 1) improving the patient experience of care (including quality and satisfaction); 2) improving the health of populations [particularly frail and vulnerable hospitalized populations], and 3) reducing the per capita cost of health care.

Program Description

AACN CSI Academy aims to empower staff nurses with the knowledge and support necessary to become leaders who guide their peers in creating unit-based change that is easily scaled hospital-wide. The AACN CSI goals are accomplished through 8 experiential workshops led by AACN CSI national faculty over a 16-month period. In addition, hands-on coaching by hospital leadership provides the participants the knowledge of how to get things done in their respective organizations.

For More Information Contact:

Karen Cox, PhD, RN, FAAN


Susan R. Lacey, PhD, RN, FAAN


Hospitals select a team of up to four nurses from one nursing unit to work with AACN CSI Academy faculty to identify challenging issues, most frequently hospital acquired conditions (HACs). The content is delivered by the AACN CSI faculty in experiential learning environments, including onsite workshops, webinars and regular consultations in person, by phone and via email. At the end of the 16-month program the CSI teams present their projects and findings at a regional Innovation Conference, hosted by AACN, for the community at large.

To facilitate the AACN CSI Academy’s commitment to share the results of these projects, the Innovation Database was launched in 2012. This is a searchable database that includes final presentations, project summaries, and toolkits that can be downloaded by anyone who accesses the site at www.aacn.org/csi. In addition, support from AACN staff is available to those who have questions about projects.

Evidence of Success

Consistent with its goals, the AACN CSI Academy has markedly improved clinical outcomes and improved the fiscal health of the participating organizations. Examples include:

  • Franciscan St. Francis Hospital - falls were reduced by 70% over two years with an annual fiscal savings of $123,383;
  • Riley Hospital for Children – the average ICU Length of Stay was reduced by .5 days for an annual fiscal savings of $4,154,500;
  • Wishard Health Services – pressure ulcers were reduced by 64% over two years for an annual fiscal savings of $582,000.   
  • Duke Raleigh Hospital – average Length of Stay for vented patients reduced by 1 day; average length of Stay for surgical patients reduced by .7 days; total vent days reduced by 17%; Ventilator-Associated Pneumonia, pressure ulcers, and falls reduced to 0 over a six month period. Total annual fiscal savings of $1,241,962.

The following quotes from CNO’s convey how the AACN CSI Academy program successfully demonstrates the value of the professional practice of nursing:

  • “I’ve never heard nurses talk about ‘fiscal impact’ before. This MUST continue!”
  • “….provided the nurses with a personal experience within the organization, positive excitement, and increased nurses’ roles in research/quality – actually changed outcomes …..brilliant program!”
  • “Need to rekindle this culture for everyone. Someone believed in them.”
  • “Staff nurses are the key to building systems of quality. This program proves just that.”