A statewide initiative integrating Quality and Safety Education for Nurses (QSEN) through academic-clinical partnerships to improve health outcomes.The purpose of this article is to describe an innovative project that contributed to the work of Quality and Safety Education for Nurses (QSEN's) second generation which resulted from the original initiative and the awareness that new environments, partnerships, and strategies were needed to improve quality and safety.  It is the only known project that served as a pilot model to disseminate the QSEN competencies across an entire state to build academic-clinical partnerships and can be replicable across the country.  (a) the need for ongoing education for both academic and clinical partners regarding the QSEN competencies as well as ongoing coaching to develop those collaborative relationships;  (b) an awareness among the partnerships of the competing time demands with their other work responsibilities to complete their QSEN project; and  (c) many unforeseen positive outcomes including the establishment of the QSEN Institute Regional Center at Jacksonville University.  Supported by a mini-grant by the Florida Blue Foundation it is the authors' beliefs that we have now moved onto the third generation of QSEN due to the leveraged opportunities to further improve health outcomes.
QSEN
(c) many unforeseen positive outcomes including the establishment of the QSEN Institute Regional Center at Jacksonville University. 
QSEN Institute Regional Center