title: Communication and collaboration: it's about the pharmacists, as well as the physicians and nurses.
abstract: OBJECTIVE
  Collaboration and communication as dimensions of patient safety climate have been measured in acute care hospital units, and discrepant viewpoints have been documented between different professional groups, particularly between physicians and nurses. In the ambulatory care setting, these groups often work more closely together throughout the day than in acute care settings, thereby enhancing effective collaboration and communication. This study sought to determine if the communication differences that are known to impact patient safety, which are found in acute care, also exist in ambulatory care.
  
  
  METHODS
  The Safety Attitudes Questionnaire, a 77-item survey of collaboration, communication and safety attitudes, was administered to the primary care staff at four Midwestern military ambulatory care clinics.
  
  
  RESULTS
  There were 107 participants consisting of nurses (n=46), nurse practitioners (n=12), pharmacists (n=10) and physicians (n=39), yielding an overall response rate of 65%. All groups rated their peer group higher than other professional groups. The ratings of nurses and physicians were very similar: 85.0% of nurses rated physicians, and 85.7% of physicians rated nurses as high or very high in communication and collaboration. Pharmacists were rated the lowest by each of the other professional groups. Only 60% of pharmacists rated physicians as high or very high.
  
  
  CONCLUSIONS
  Collaboration and communication ratings among physicians and nurses appear to be higher in the ambulatory care setting than in the acute care. However, interactions with pharmacists are more problematic, perceived as adversarial. Teamwork training that focuses on specific interactions among professional groups should target these concerns.
authors.affiliation: Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. LMHolden@Partners.org
authors.forename: Lela M
authors.initials: LM
authors.lastname: Holden
authors.forename: D D
authors.initials: DD
authors.lastname: Watts
authors.forename: P H
authors.initials: PH
authors.lastname: Walker
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D001291:Attitude of Health Personnel; D003299:Cooperative Behavior; D006801:Humans; D033183:Interdisciplinary Communication; D015146:Midwestern United States; D008887:Military Medicine; D009726:Nurses / Q000523:psychology*; D061214:Patient Safety / Q000592:standards*; D010595:Pharmacists / Q000523:psychology*; D010820:Physicians / Q000523:psychology*; D011320:Primary Health Care; D017751:Safety Management / Q000592:standards; D011795:Surveys and Questionnaires; D000078329:Workforce