By Tanner Lambson and Liz Torrey 

Last summer, Katie Rodman, FNP, found herself in an unexpected position: lying in a hospital bed on the very same floor at VCU Medical Center where she has cared for patients for two decades. 

A sudden medical crisis turned the VCU Health colleagues she’s worked alongside into the care team that also saved her life. 

“If I had any doubt in my mind that VCU and our cardiac surgery and cardiology teams weren’t the best of the best, that [experience] got rid of it,” she said. “My team is a shining example of how to do things right and how to take care of each other.” 

Rodman is a nurse practitioner with VCU Health Pauley Heart Center’s cardiothoracic surgery inpatient advanced practice provider team — a group whose roles have rapidly expanded in health systems nationwide. Advanced practice provider (APP) is an umbrella term for a wide variety of health care workers — including nurse practitioners (NPs) and physician assistants (PAs) — who diagnose, treat, prescribe, perform procedures and co-lead patient care across inpatient and outpatient settings, in collaboration with their physician colleagues. 

Over the past five years, Pauley has invested in APP growth, welcoming the opportunity to engage the expertise of talented APPs while recognizing their ability to extend excellent cardiac care across clinics, hospital units and communities. 

As of 2025, APPs make up nearly 41% of the health care workforce in the United States. Since 2020, Pauley’s outpatient cardiology APP team has grown from four to 27 providers, and more roles are planned to be added in the near future. 

Rodman works alongside colleagues such as Kristyn Rudisill, PA-C; APP director of the Center for Advanced Practice and APP lead for VCU Health Pauley Heart Center, and Vicki Green, FNP-BC; APP lead for inpatient cardiology, who together help shape the strategy and impact of Pauley’s evolving APP workforce. 

The growing footprint of advanced practice providers in cardiology 

APPs have a long history of expanding health care access. At Pauley Heart Center, APPs are deeply integrated into both inpatient and outpatient cardiovascular care. Their training complements — but does not replace — the work of their physician colleagues.  

Physicians undergo medical school and residency with broad and deep specialty training, leading complex diagnostics, surgical care and advanced procedures. APPs complete graduate‑level programs that prepare them for independent clinical practice, allowing them to provide ongoing patient management, follow‑up, and education, as well as certain procedures, all while collaborating closely with physician partners. 

As APPs become increasingly integral members of VCU Health teams, our value extends far beyond improving access. We are essential to sustaining the quality, safety and continuity of care that our patients deserve.” 

Paula Brooks, DNP, associate vice president of advanced practice providers at VCU Health

APPs at VCU Health were a small fraction of the care team when Rodman started in the cardiac surgery intensive care unit (CSICU) in 2005. Rodman herself was just the second APP hired to work in the CSICU.  

At that time, she said, “there was this new idea of having someone who specialized in that patient population manage the patients in the ICU so the surgeon can go down and be in the operating room, where they are most valuable. APPs increase the productivity of teams tremendously.” 

As cardiology grew, so did the APP footprint. Initially supporting general cardiology, heart failure and electrophysiology, APPs at Pauley now partner with specialists in cardio‑oncology, cardio‑obstetrics and adult congenital heart disease. Rudisill has seen firsthand how this investment has reshaped access to care for patients across Virginia. 

“We’re seeing more new patient visits, more follow-ups and we’re providing more specialty care to patients in the community and across the state,” Rudisill said. “The APP team’s growth has truly improved access for patients.” 

That increase in access is measurable. Access to Pauley’s cardiology clinic grew by 60% over the past six years, from more than 44,000 appointments in 2019 to more than 71,000 in 2025. 

Expanding patient access to quality heart care 

Green, who leads the inpatient general cardiology APP team, has seen the role of APPs evolve.   

In the past, APPs on Pauley’s inpatient cardiology teams would work alongside attending physicians on rounds, planning and direct patient care.  

“We have moved away from that model,” Green said. “We have an attending physician available if we have questions, but we see patients on our own and we formulate action plans for patients.”  

The impact? More efficient decision-making and better use of physician time for more complex cases, while APPs manage routine and moderate‑complexity care.  

The presence of APPs is also expanding access to cardiovascular procedures. Within Pauley’s electrophysiology team, for example, APPs are training to perform procedures like cardioversions and loop recorder implantations, which previously required a physician. 

“To offer these as an outpatient procedures is a huge opportunity in terms of access,” Rudisill said. “That will also facilitate increased time for complex procedures to be completed by the physicians in the EP lab.”

We’re seeing more new patient visits, more follow-ups and we’re providing more specialty care to patients in the community and across the state. The APP team’s growth has truly improved access for patients. 

Kristyn Rudisill, PA-C, APP director of the Center for Advanced Practice

 Across specialties, collaboration remains one of Pauley’s strongest cultural assets.  

“The physicians at Pauley are highly supportive of the APPs,” Rudisill said. “In fact, some of the physicians are our biggest advocates. You don’t always find that outside of the VCU Health System.” 

“There is a collaboration that exists across Pauley, across cardiology and cardiac surgery and vascular surgery, in every specialty and subspecialty. The physicians and the APPs work together,” Rodman added. “I think that’s something special at VCU that allows patients to get directly to what they need.” 

APPs also lead new, innovative programs at Pauley. 

The new outpatient heart failure management program, established with funding from the state of Virginia, is led by nurse practitioner Rachel Venable. The program integrates clinical support with social work and community health workers and helps patients navigate their diagnoses, treatment plans and social determinants of health, such as housing instability, food insecurity and lack of transportation. In its first year, the program helped to reduce heart failure appointment no-show rates by more than 50%. 

The future: Growth, leadership and system‑wide impact 

Today, VCU Health employs more than 700 APPs across the system. New leadership structures support their growth. In early 2025, VCU Health hired Paula Brooks, DNP, as the health system’s first associate vice president of advanced practice providers. APP directors, like Rudisill, report to Brooks and help shape a system-wide strategy. 

“With the leadership of people like Kristyn, there is a lot more inclusiveness and recognition, appreciation and acknowledgement of the importance of APPs [at VCU Health],” Rodman said. “We have a seat the table and we have a voice.” 

“Advanced practice providers deliver cost‑effective, high‑quality care to every population we serve,” Brooks said. “As APPs become increasingly integral members of VCU Health teams, our value extends far beyond improving access. We are essential to sustaining the quality, safety and continuity of care that our patients deserve.” 

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