title: An international hospital outcomes research agenda focused on nursing: lessons from a decade of collaboration.
abstract: OBJECTIVE
  To describe the origins, design and outcomes of an international hospital outcomes collaboration focused on nursing issues.
  
  
  BACKGROUND
  Across countries with different cultures and histories, nursing and healthcare leaders face similar issues with respect to workforce supply, quality and safety of care and financial constraints. Until researchers began using common research protocols to investigate structure, and outcomes variables in hospital nursing across countries, studying the aspects of work environments most important to patients and nurses in large numbers of hospitals was very difficult, if not impossible.
  
  
  METHODS
  Review/essay.
  
  
  CONCLUSIONS
  The international collaborations discussed in this article led by the University of Pennsylvania have found remarkable similarities in the experiences of hospital nurses across countries in terms of positive and negative aspects of their work, sizeable differences across hospitals within countries in working conditions and investments in high-quality practice environments, and consistent evidence of connections between modifiable features of nurses' work environments and both patient well-being and factors influencing workforce stability.
  
  
  CONCLUSIONS
  International research collaborations allow benchmarking of countries and facilities within countries on work environment factors that are important to the provision of high quality nursing care. Results of this ongoing research initiative have helped strengthen the case that optimal management of practice environments for nurses in hospitals and other settings are a key strategy for optimising patient outcomes.
authors.affiliation: Center for Health Outcomes and Policy Research, University of Pennsylvania, Philadelphia, PA 19104-6096, USA. sclarke@nursing.upenn.edu
authors.forename: Sean P
authors.initials: SP
authors.lastname: Clarke
authors.forename: Linda H
authors.initials: LH
authors.lastname: Aiken
mesh_terms: D003625:Data Collection; D006761:Hospitals; D006801:Humans; D007391:International Cooperation; D009726:Nurses / Q000523:psychology; D015399:Nursing Research; D009936:Organizational Innovation; D017063:Outcome Assessment, Health Care