title: Intentional partnering: a grounded theory study on developing effective partnerships among nurse and physician managers as they co-lead in an evolving healthcare system.
abstract: OBJECTIVE
  The aim of this study was to describe the process of how nurse and physician managers in formalized dyads work together to address clinical management issues in the surgical division of one hospital setting.
  
  
  BACKGROUND
  Nurse and physician managers are uniquely positioned to co-lead and transform healthcare delivery. However, little is known about how this management dyad functions in the healthcare setting.
  
  
  METHODS
  A constructivist grounded theory approach was used to investigate the process of how nurse and physician managers work together in formalized dyads in an urban Canadian university affiliated teaching hospital.
  
  
  METHODS
  Data collection occurred from September 2013-August 2014. Data included participant observation (n = 142 hours) and intensive interviews (n = 36) with nurse-physician manager dyads (12 nurses, 9 physicians) collected in a surgical department. Theoretical sampling was used to elaborate on properties of emerging concepts and categories.
  
  
  RESULTS
  A substantive theory on 'intentional partnering' was generated. Nurses' and physicians' professional agendas, which included their interests and purposes for working with each other served as the starting point of 'intentional partnering'. The theory explains how nurse and physician managers align their professional agendas through the processes of 'accepting mutual necessity', 'daring to risk (together)' and 'constructing a shared responsibility'. Being credible, earning trust and safeguarding respect were fundamental to communicating effectively.
  
  
  CONCLUSIONS
  Intentional partnering elucidates the relational components of working together and the strategizing that occurs as each partner deliberates on what he or she is willing to accept, risk and put into place to reap the benefits of collaborating.
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Québec, Canada.
authors.forename: Christina
authors.identifier: http://orcid.org/0000-0001-7054-4001
authors.initials: C
authors.lastname: Clausen
authors.affiliation: McGill University Health Center, Ingram School of Nursing, McGill University, Montreal, Québec, Canada.
authors.forename: Melanie
authors.identifier: http://orcid.org/0000-0001-8707-9855
authors.initials: M
authors.lastname: Lavoie-Tremblay
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Québec, Canada.|Centre for Nursing Research, Jewish General Hospital, Montreal, Québec, Canada.
authors.forename: Margaret
authors.initials: M
authors.lastname: Purden
authors.affiliation: Département d'administration de la santé, Faculté de Médecine, Vice-doyenne Études, École de santé publique l'Université de Montréal, Québec, Canada.
authors.forename: Lise
authors.initials: L
authors.lastname: Lamothe
authors.affiliation: Ingram School of Nursing, McGill University, Montreal, Québec, Canada.
authors.forename: Héléne
authors.initials: H
authors.lastname: Ezer
authors.affiliation: CIUSSS Ouest-de-l'Île-de-Montréal, Pointe-Claire, Québec, Canada.
authors.forename: Lynne
authors.initials: L
authors.lastname: McVey
mesh_terms: D000328:Adult; D002170:Canada; D003695:Delivery of Health Care / Q000458:organization & administration*; D005260:Female; D066296:Grounded Theory; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008875:Middle Aged; D009740:Nursing Staff / Q000523:psychology*; D008486:Physician Executives / Q000523:psychology*; D013531:Surgicenters / Q000458:organization & administration*
keywords: co-leadership; collaboration; grounded theory; management dyad; nurse-physician