The impact of nurse/physician collaboration on patient length of stay |
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Authors: | DANA TSCHANNEN PhD RN and BEATRICE J KALISCH PhD RN FAAN |
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Institution: | Clinical Assistant Professor;and Director and Titus Distinguished Professor of Nursing, Nursing Business and Health Systems, University of Michigan, Ann Arbor, MI, USA |
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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. |
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Keywords: | nurse nurse/physician collaboration patient length of stay patient outcomes |
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