Interdisciplinary Communication and Collaboration Among Physicians, Nurses, and Unlicensed Assistive Personnel.
Purpose Historically, health care has primarily focused on physician, nurse, and allied healthcare provider triads. Using a phenomenological approach, this study explores the potential for hospital-based interdisciplinary care provided by physicians, nurses, and unlicensed assistive personnel (UAPs)...
| Published in: | Journal of Nursing Scholarship Vol. 47; no. 3; pp. 275 - 285 |
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| Main Authors: | , , , |
| Format: | research tables/charts Journal Article |
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Wiley-Blackwell
May2015
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=103793828&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 103793828 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 15276546 6QP jtl: Journal of Nursing Scholarship issn: 15276546 maglogo: Y pubinfo: dt: May2015 vid: 47 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 103793828 102288509 102288509 10.1111/jnu.12130 NLM25801466 103793828 ppf: 275 ppct: 10 formats: tig: atl: Interdisciplinary Communication and Collaboration Among Physicians, Nurses, and Unlicensed Assistive Personnel. aug: au: Lancaster, Gwendolyn Kolakowsky-Hayner, Stephanie Kovacich, Joann Greer-Williams, Nancy affil: Assistant Nursing Care Coordinator, Omicron Delta, Mount Sinai St. Luke's Hospital sug: subj: Communication Nurse-Physician Relations Health Personnel, Unlicensed Collaboration Human Purposive Sample Phenomenological Research Nonprobability Sample Convenience Sample Semi-Structured Interview Conceptual Framework Hospitals New York New York Interview Guides Male Female Adult Sample Size Determination Role Teamwork World Wide Web Information Resources Adult: 19-44 years Male Female ab: Purpose Historically, health care has primarily focused on physician, nurse, and allied healthcare provider triads. Using a phenomenological approach, this study explores the potential for hospital-based interdisciplinary care provided by physicians, nurses, and unlicensed assistive personnel (UAPs). Design This phenomenological study used a purposive nonprobability, criterion-based, convenience sample from a metropolitan hospital. Theoretical Foundation Malhotra's (1981) Schutzian lifeworld phenomenological orchestra study provided the theoretical basis for the conductorless orchestra model, which guided this study. In an orchestra, each member sees and hears the musical score from a different vantage point or perspective and has a different stock of knowledge or talent; however, members work together to produce a cohesive performance. Like the orchestra, individual talents and perspectives of physicians, nurses, and UAPs can be collaboratively blended to create a symphony: enhanced patient-centered care. Methods Qualitative semistructured face-to-face, individual interviews were carefully transcribed and coded with the aid of NVivo 9, a qualitative data analysis software program, to discover emergent patterns and themes. Findings The study suggests that most of the time physicians, nurses, and UAPs operate as separate healthcare providers who barely speak to each other. Physicians see themselves as the primary patient care decision makers. Many physicians acknowledge the importance of nurses' knowledge and expertise. On the other hand, the study indicates a hierarchical, subservient relationship among nurses and UAPs. Physicians and nurses tend to work together or consult each other at times, but UAPs are rarely included in any type of meaningful patient discussion. Conclusions Since physicians, nurses, and UAPs each provide portions of patient care, coordination of the various treatments and interventions provided is critical to prevent errors and fragmentation of care. Tensions, misunderstandings, and conflicts caused by differences of opinions and interests can interfere with effective interdisciplinary communications and collaboration. Improving patient safety in the hospital requires addressing the current hierarchical professional structure inherent in healthcare delivery. A hospital patient care model based on the conductorless orchestra model would mitigate hierarchy; recognize physician, nurse, and UAP contributions to care; promote improved communication and collaboration; and enhance patient safety. Clinical Relevance Study results provide additional information supporting interdisciplinary communication and collaboration education and training among physicians, nurses, and UAPs to support positive patient care outcomes. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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