Shari Dingle Sandifer created Avant Healthcare Professionals in 2003, in the midst of a long-running nurse shortage. When visa backlogs for foreign nurses shut down the pipeline of available candidates, Sandifer repositioned the company, diversifying the types of employment-based visas Avant used and expanding its client base to include skilled nursing facilities, home care companies, and clinics, as well as their hospital partners. Sandifer also helped launch the American Association of International Healthcare Recruitment, which lobbies on behalf of the industry.