Association between nurse-physician collaboration and patient outcomes in three intensive care units.
OBJECTIVE
To investigate the association of collaboration between intensive care unit (ICU) physicians and nurses and patient outcome.


METHODS
Prospective, descriptive, correlational study using self-report instruments.


METHODS
A community teaching hospital medical ICU, a university teaching hospital surgical ICU, and a community non-teaching hospital mixed ICU, all in upstate New York.


METHODS
Ninety-seven attending physicians, 63 resident physicians, and 162 staff nurses.


METHODS
When patients were ready for transfer from the ICU to an area of less intensive care, questionnaires were used to assess care providers' reports of collaboration in making the transfer decision. After controlling for severity of illness, the association between interprofessional collaboration and patient outcome was assessed. Unit-level organizational collaboration and patient outcomes were ranked.


METHODS
Healthcare providers' reported levels of collaboration, patient severity of illness and individual risk, patient outcomes of death or readmission to the ICU, unit-level collaboration, and unit patient risk of negative outcome.


RESULTS
Medical ICU nurses' reports of collaboration were associated positively with patient outcomes. No other associations between individual reports of collaboration and patient outcome were found. There was a perfect rank order correlation between unit-level organizational collaboration and patient outcomes across the three units.


CONCLUSIONS
The study offered some support for the importance of physician-nurse collaboration in ICU care delivery, a variable susceptible to intervention and further study.
Baggs
J G
JG
School of Nursing, University of Rochester, NY 14642-8404, USA.
Schmitt
M H
MH
Mushlin
A I
AI
Mitchell
P H
PH
Eldredge
D H
DH
Oakes
D
D
Hutson
A D
AD
D018806:APACHE; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003299:Cooperative Behavior; D003657:Decision Making; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration* / Q000706:statistics & numerical data; D007902:Length of Stay; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009518:New York; D010348:Patient Care Team; D010360:Patient Transfer; D019555:Physician-Nurse Relations; D011383:Progressive Patient Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016896:Treatment Outcome