Rachel Start is the associate vice president of medical, behavioral, emergency, and dialysis services at Rush University Medical Center. Rachel was co-chair of the AAACN nurse sensitive indicator task force and the lead editor on the Ambulatory Care Nurse-Sensitive Indicator Industry Report: Meaningful Measurement of Nursing in the Ambulatory Patient Care Environment (May 2016). She has represented AAACN as an advocate for advancing nursing practice in ambulatory care at the ANCC Magnet Commission, the National Alliance for Quality Care, AONL, Vizient, Press Ganey, AACN, and other organizations. She is currently on the AONL care continuum committee, AAACN leadership SIG, and AAACN nursing essentials task force as a practice partner. She has published and presented extensively on the imperative for meaningful measurement and nursing practice advancement as related to the shifting healthcare landscape at numerous national venues. She has consulted with numerous organizations related to nursing practice, structural empowerment, Magnet principles, and innovative emergent roles. She founded the Illinois Ambulatory Care Nurse Practice Consortium, a local networking group of AAACN, which serves as the ambulatory care nursing voice in Illinois on such important state legislative topics as the nurse practice act. Rachel is also currently working on her PhD degree at Loyola University, researching the role of the ambulatory care nurse.