A Conceptual Model of Nurse-Physician Collaboration in the Intensive Care Unit

Abstract

Background: Nurse-physician collaboration in the Intensive Care Units (ICUs) is an important component of a healthy work environment and is associated with better outcomes. Objective: The purpose of this study was to better understand collaboration from the perspective of ICU nurses and physicians to develop a conceptual model. Donabedian’s Heath Quality Model served as the framework for this study, and themes were situated within the context of structures, processes, and outcomes associated with nurse-physician collaboration. Methodology: This study utilized a qualitative descriptive design to better understand nurse-physician collaboration. The research team conducted semi-structured in-depth interviews with four ICU physicians and six ICU nurses from November 2018 through February 2019. Results: Top themes associated with structure included Accessible, Debrief, Experience, Leadership, and Team. Within the model, the Impact of Acuity on collaboration is illustrated. Process themes included Advocate, Rounding, and Professionalism. Outcomes consisted of Patient Outcomes, Nurse Outcomes, and Physician Outcomes. “Process outcomes” include Shared Decision Making, United Front, and Communication. Conclusion and Recommendations: Hospital administrators should focus on these themes when working to improve nurse-physician collaboration. This model can serve as a framework to coordinate investments to support collaboration.