Nursing leadership and influence in practice domains at a Veterans Affairs Health Care System

Background: Studies in Veteran populations have examined disparities in health service use, care quality, outcomes and increased demands for behavioral health.Purpose: The purpose is to describe the development of nursing leadership roles that influenced practice improvements and demonstrated outcomes related to health disparities in a Veterans Affairs (VA) population over a 12-year period.Methods: The Sundean and colleagues' concept analysis of nurse leadership influ-ence was applied to frame the initiative process and impacts.Discussion: Antecedents and processes that facilitated leadership development included mentorship, disparities expertise, partnerships, consultation, scholar-ship, dissemination, advocacy, education, and strong coauthor collaboration. Improvements and outcomes included access to services, improved health indi-cators, tools, workforce, funding, innovations, and nurse investigator studies, consistent with VA priorities and policy related to disparities and equity. Limita-tions and barriers were addressed.Conclusion: This initiative models' strategies to increase nurse leadership in health equity and care transformation in health systems and community practices.