Nurse/physician collaboration: action research and the lessons learned

J Nurs Adm. 2001 May;31(5):223-32. doi: 10.1097/00005110-200105000-00002.

Abstract

Objective: Finding time to add to nursing knowledge while solving problems in a fast-paced healthcare environment is the ultimate challenge for nurse executives. At one hospital, use of an action research model to measure collaboration in nurse/physician led interdisciplinary teams improved the intervention and the approach to outcome measurement.

Background: Many hospital nurse executives promote collaborative practice, and yet, innovations introduced to foster collaboration are rarely studied prospectively. The best-known data on collaboration is predominantly from correlational studies. Within the rapidly changing practice setting, action research may be a more legitimate strategy for studying interventions longitudinally.

Methods: An action research pretest/posttest design using Baggs' Collaboration and Satisfaction About Care Decisions measured collaboration before and after several interventions to improve nurse/physician collaboration. The sample consisted of 87 pretest and 65 posttest registered nurses working on three medical-surgical units and two intensive care units (ICU).

Results: Collaboration scores in the ICUs were higher than those in previous research, but the posttest indicated no significant difference in either ICU nurse or medical-surgical nurse scores. Higher ICU scores may have been related to the organizational focus on teams. A strong significant correlation between nurse report of level of collaboration and satisfaction with decision making was uncovered.

Conclusions: This study contributes to the nurse/physician collaboration literature in that it was longitudinal, used a reliable and valid instrument, and surveyed nurses in medical/surgical units as well as the ICU. Some of the difficulties and benefits of research in today's practice setting are illustrated.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Attitude of Health Personnel
  • Cooperative Behavior*
  • Decision Making, Organizational
  • Female
  • Health Services Research / organization & administration*
  • Hospital Restructuring / organization & administration
  • Humans
  • Inservice Training
  • Job Satisfaction
  • Longitudinal Studies
  • Los Angeles
  • Male
  • Medical Staff, Hospital / education
  • Medical Staff, Hospital / psychology*
  • Middle Aged
  • Models, Nursing*
  • Nursing Administration Research / organization & administration*
  • Nursing Staff, Hospital / education
  • Nursing Staff, Hospital / psychology*
  • Outcome Assessment, Health Care
  • Patient Care Team / organization & administration*
  • Physician-Nurse Relations*
  • Total Quality Management / organization & administration*