Calling the US system of health care complex is an understatement. It has over 5900 companies providing health insurance with approximately 18 million health care workers and an annual cost of $3.5 trillion.1–3  Such complexity can lead to estrangement of practice among different health care providers and impede the common objective of providing quality health care. Practice silos are common in health care disciplines including advanced practice nursing. For example, the separation between acute and primary care advanced practice registered nurses (APRNs) occurs in education and training as well as by specialty track. After mastering the “three Ps” (advanced health physical assessment, pharmacology, and physiology/pathophysiology), students in these tracks progress to divergent didactic and clinical coursework. Although both student groups are preparing to work as APRNs, they do so separately. Once they enter the workforce, they become focused on the...

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