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The impact of nurse/physician collaboration on patient length of stay
Authors:DANA TSCHANNEN PhD  RN  and BEATRICE J KALISCH PhD  RN  FAAN
Institution:Clinical Assistant Professor;and Director and Titus Distinguished Professor of Nursing, Nursing Business and Health Systems, University of Michigan, Ann Arbor, MI, USA
Abstract:Aim  This study examines the relationship between nurse/physician collaboration and patient length of stay (LOS).
Background  The quality of nurse/physician relationships has been shown to have an impact on patient outcomes. As the acuity level of patients admitted to hospitals continue to rise, the need for collaboratively determined care is essential for avoiding errors and promoting quality.
Methods  Data were collected on four units located in two Midwest hospitals. Nurses ( n  = 135) were asked to complete a survey seeking perceptions of nurse/physician collaboration. The survey data were then linked with patient ( n  = 310) data, including LOS, diagnostic-related groups (DRG) category and other patient-specific characteristics.
Results  Perceptions of nurse/physician collaboration were positively linked with actual LOS ( P  < 0.001) and inversely related to deviation from expected LOS (i.e. patient stay longer than expected) ( P  < 0.01). Patients receiving care from nurses who perceived greater collaboration were elderly and had higher levels of acuity. Longer LOS for these patients may be a result of their higher acuity level.
Conclusions and implications for Nursing Management  This study found that collaboratively determined care may result in longer LOS, but could prevent complications that may otherwise go untreated. Nurse administrators must implement strategies that foster the development of nurse/physician collaboration.
Keywords:nurse  nurse/physician collaboration  patient length of stay  patient outcomes
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