Journal of Emergency Nursing (JEN), published as part of the 50th anniversary celebrations of the Emergency Nursing Association (ENA). The themes for this issue include ED flow and crowding, 1,2 critical care, 1,3-8 vascular emergencies, 6,7,9,10 and cultural or organizational patient-centered care. 11,12 Emergency nurses strive to develop and implement evidence-based interventions, which are often pragmatic interventions. Moreover, JEN readers practice in widely diverse emergency settings. To support the consistent spread of effective emergency nursing innovations across these diverse settings, this editorial introduces the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) Planning and Evaluation Framework for integrating scientific advances with emergency nursing practice. 13,14 All evidence-based guidelines and interventions, however widely adopted in our current time, were born as a single idea. Nurses who provide direct patient care are positioned ideally to create care innovation ideas. Most emergency nurses are well versed in the Plan-Do-Study-Act quality improvement process of rapid, incremental, and consistent practice changes. 15 However, the process to test adequately the efficacy and effectiveness of an intervention to justify the full adoption