A DECADE Development OF by Dr. Mary C. Tonges It has been my privilege and pleasure to serve as Senior Vice President and Chief Nursing Officer of the University of North Carolina Hospitals (UNCH) since August 2002. In the ensuing years the UNCH Nursing Division has developed and implemented numerous initiatives that have resulted in very strong performance in the four key domains of clinical quality, patient experience, workforce engagement, and finance. Figure 1 presents an overview of the sequence of programs and achievements from 2004 to 2014-a decade of development. 14