Association between nurse-physician collaboration and patient outcomes in three intensive care units

Objective: To investigate the association of collaboration between intensiv e care unit (ICU) physicians and nurses and patient outcome. Design: Prospective, descriptive, correlational study using self-report ins truments. Settings: A community teaching hospital medical ICU, a university teaching hospital surgical ICU, and a community nonteaching hospital mixed ICU, all in upstate New York, Subjects: Ninety-seven attending physicians, 63 resident physicians, and 16 2 staff nurses. Procedure: When patients were ready for transfer from the ICU to an area of less intensive care, questionnaires were used to assess care providers' re ports of collaboration in making the transfer decision. After controlling f or severity of illness, the association between interprofessional collabora tion and patient outcome was assessed. Unit-level organizational collaborat ion and patient outcomes were ranked. Measures: Healthcare providers' reported levels of collaboration, patient s everity of illness and individual risk, patient outcomes of death or readmi ssion to the ICU, unit-level collaboration, and unit patient risk of negati ve outcome. Main Results: Medical ICU nurses' reports of collaboration were associated positively with patient outcomes. No other associations between individual reports of collaboration and patient outcome were found. There was a perfec t rank order correlation between unit-level organizational collaboration an d patient outcomes across the three units. Conclusions: The study offered some support for the importance of physician -nurse collaboration in ICU care delivery, a variable susceptible to interv ention and further study.