As a registered nurse for over 30 years, Sandy Roth is currently the Director of Ambulatory Care Services and the Practice Leader for Kaiser Permanente in San Diego. She is responsible for directing operations for 6 medical office buildings covering the north county of San Diego servicing more than 145,000 members. As Practice Leader she ensures the structure of nursing leadership, education, research, and assists with identifying, directing, implementing and evaluating strategic initiatives related to the practice of ambulatory care. Her responsibilities have included being the co-lead for the immunization programs throughout the service area, including influenza and pneumonia vaccines. Prior to her current position she created and directed the department of Population Based Medicine which was responsible for developing and instituting strategies to improve cancer screenings and chronic disease management. She received her Masters of Science in Nursing Leadership and Health Care Systems from Regis University and is an active member in AAACN.