Nurse/physician collaboration: action research and the lessons learned

Finding time to add to nursing knowledge while solving problems in a fast-paced healthcare environment is the ultimate challenge for nurse executives. At one hospital, use of an action research model to measure collaboration in nurse/physician led interdisciplinary teams improved the intervention and the approach to outcome measurement.

Many hospital nurse executives promote collaborative practice, and yet, innovations introduced to foster collaboration are rarely studied prospectively. The best-known data on collaboration is predominantly from correlational studies. Within the rapidly changing practice setting, action research may be a more legitimate strategy for studying interventions longitudinally.

An action research pretest/posttest design using Baggs' Collaboration and Satisfaction About Care Decisions measured collaboration before and after several interventions to improve nurse/physician collaboration. The sample consisted of 87 pretest and 65 posttest registered nurses working on three medical-surgical units and two intensive care units (ICU).

Collaboration scores in the ICUs were higher than those in previous research, but the posttest indicated no significant difference in either ICU nurse or medical-surgical nurse scores. Higher ICU scores may have been related to the organizational focus on teams. A strong significant correlation between nurse report of level of collaboration and satisfaction with decision making was uncovered.

This study contributes to the nurse/physician collaboration literature in that it was longitudinal, used a reliable and valid instrument, and surveyed nurses in medical/surgical units as well as the ICU. Some of the difficulties and benefits of research in today's practice setting are illustrated.