Rachel Start is the director of ambulatory nursing, nursing practice, and Magnet Performance at Rush Oak Park Hospital in Chicago, Illinois. Rachel was co-chair of the American Academy of Ambulatory Care Nursing (AAACN) Nurse Sensitive Indicator Taskforce 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 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 Group and AACN Nursing Essentials TaskForce 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 Nurse Practice Consortium, a local networking group of AAACN, which serves as the ambulatory nursing voice in Illinois on such important state legislative topics as the nurse practice act. Rachel is also currently working on her PhD at Loyola University, researching the role of the ambulatory nurse.