By ANA Staff—January
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
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
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
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
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
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
“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
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.