Making it Work: A Qualitative Study of Nurse Practitioner-Physician Collaboration in Long-Term Care Homes

BackgroundNurse practitioners (NPs) and physicians are essential to providing acute, episodic and palliative care in long-term care (LTC) homes and preventing unnecessary hospital transfers.ObjectivesTo explore the attributes of effective NP-physician collaboration in LTC and identify barriers to developing it.MethodsAn exploratory qualitative study was conducted using semi-structured interviews with 10 NPs and six physicians practicing in LTC homes in Ontario, Canada. Recruited individuals were not matched NP-physician dyads. Data were analyzed using inductive thematic analysis.ResultsTwo distinct NP-physician practice models emerged: one characterized by successful collaboration, and the other by failed partnership. Findings are presented in the form of vignettes illustrating key differences between the models. Successful collaboration featured resident-centered care, non-hierarchical relationships, and clearly defined roles. Barriers included lack of trust, high NP workload, and role ambiguity.ConclusionNP-physician collaboration can improve care for LTC residents. Successful implementation requires clear communication, role clarity, and leadership engagement to support NP integration and foster effective interprofessional relationships.