Collaborative Health Care: How Nurses Work in Team-Based Settings

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By ANA Staff—January 2016

Fewer falls, shorter stays and more morning discharges: These are just a few of the results nurses at Aurora West Allis Medical Center in West Allis, Wisconsin, said they saw after the facility instituted a nurse-physician collaboration model.

 

A report by the Robert Wood Johnson Foundation explains that Aurora West Allis cut fall rates in half after instituting a collaborative care model in which nurses and physicians worked more closely together. Length of stay was reduced by 0.6 days, and discharges before noon went from 10 percent to 30 percent. “Fall prevention was no longer the ‘nurses’ job,’ and could be shared by all the professionals working on the team,” the report says.

Impressive positive results like those seen at Aurora West Allis are helping to encourage more health care providers to consider this model for their own staffs, and that can be a good thing for nurses. Nurses who work in collaborative settings can work to their full scope of practice and raise the profile of nurses in the industry.

What Is Collaborative Care?

ANA’s newly released Nursing: Scope and Standards of Practice, Third Edition defines interprofessional collaboration as:

 

Integrated enactment of knowledge, skills, and values and attitudes that define working together across the professions, with other health care workers, and with patients, along with families and communities, as appropriate to improve health outcomes.

 

According to the Robert Wood Johnson Foundation, some of the hallmarks of a interprofessional collaboration include:

  • Putting patients first.

  • A commitment from leadership to make interprofessional collaboration an organizational priority.

  • A level playing field that values contributions from all practitioners working at “the top of their license.”

  • Effective team communication.

“This type of collaboration requires a culture that promotes shared accountability in providing care sharply focused on meeting the health needs of the patient,” says Linda Cassidy, MSN, MEd, RN, CCNS, clinical practice specialist at the American Association of Critical-Care Nurses. “Collaborative health care is a committed partnership that strives for excellence in patient care and outcomes.”

 

Nurses in particular can thrive in collaborative care models. “We’re great team workers because we’re reliable, task-oriented and project-oriented,” says Susan Alexander, DNP, ANP-BC, ADM-BC, clinical associate professor and doctor of nursing practice coordinator at the College of Nursing, University of Alabama in Huntsville. “We’re going to get it done.”

Goals of Collaborative Care

 

While collaborative care focuses on obtaining interprofessional input, it also aims to get different specialties— such as mental or behavioral health, public health, physical therapy or nutrition — to work together.

 

“Health care has become increasingly complex,” Cassidy says. “Effective collaborative health care is synergistic, efficient and contributes to care that encourages joint participation of all team members with patients and families.” Results include improved quality outcomes, patient experience, patient safety and use of resources.

 

Best of all, collaborative health care acknowledges the expertise and contribution of all members of the health care team and provides meaningful recognition to them, Cassidy says.

 

The Nurse’s Role in a Team-Based Setting

 

Nursing is the only clinical profession whose members are trained to understand the roles of other care providers, says Louise Weadock, MPH, RN, CEO of Access Nursing. The nurse’s ability to comprehensively assess the patient’s clinical, emotional and social situation and draw upon the available resources to create a patient-centric care plan can help in playing an important part in collaborative care.

 

The training nurses get sets them up to be effective players in a collaborative care environment, Weadock says. Their adaptability, empathy, communication skills and commitment to follow through on care make them strong leaders on a care team and key team players. For example, nurses can draw upon their training in communication, as it’s critical to collaborative care, Weadock says, whether it’s verbal, written or electronic.

 

“We can’t work in silos any longer,” Alexander says. “Credentials are important, but they don’t create leaders and they don’t necessarily foster collaboration.”

 

As 24/7 providers of patient care in hospitals, nurses have a unique view of how care is provided, Cassidy says. “Nurses can lead the way by being role models in honest and open dialogue with team members about the effectiveness and quality of the patient care and the health of the work environment.”

 

ANA offers several courses that teach nurses how to build partnerships across departments and specialties to work better together at the full scope and standards of nursing practice.

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