Date of Award

January 2016

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Lisa Summers


The high performing patient care team is now widely recognized as an essential model for constructing a more patient-centered, coordinated, and effective system of health care delivery. In order to achieve these goals, health care teams need diverse members with flexible leadership. Unfortunately, too many members of the health care team are burdened by unnecessary supervision requirements, and efforts to reform scope of practice laws have met with resistance from organized medicine. In 2014, the American Medical Association (AMA) launched, “Physician-led Team Based Care”, a campaign that espouses a model of team-based care where physicians oversee advanced practice registered nurse (APRN) practice, as well as all other members of the health care team. This campaign has confused the popular model of team-based health care with individual licensure authority in the legislative arena, which has prevented lifting regulatory barriers to APRN practice in some states. Furthermore, the AMA seeks to legislate the leadership, supervision, and control of the health care team. This paper describes the scholarly process of creating a toolkit that will enhance advocacy at the state level and better prepare state nursing organizations, advocates, and legislators in promoting full practice authority (FPA) for APRNs and a model of team-based health care that effectively utilizes all members of the team.


This is an Open Access Thesis.

Open Access

This Article is Open Access