the aacn, along with nurse executives and nurse educators designed the clinical nurse leader role (the first new role in nursing in 35 years) in response to the institute of medicine's (iom) comprehensive report on medical errors, "to err is human: building a safer health system", released in november 1999. the report, extrapolating data from two previous studies, estimates that somewhere between 44,000 and 98,000 americans die each year as a result of medical errors.