In a new research study at the Columbia University School of Nursing, researchers found that nurse practitioners (NPs) who were able to care for patients independently had better relationships with healthcare administrators and improved teamwork with physicians. The study involved 314 nurse practitioners from hospital-based clinics, community health centers, and physicians’ offices, measuring their relationship-with-leadership using a professional questionnaire. Each unit of increase on the relationship-with-leadership score led to an improved score on perceived teamwork between NPs and physicians.
This study from Columbia Nursing is one of the first of its kind to directly explore possible contributors to a sense of teamwork between NPs and physicians. Previous studies show that health outcomes are significantly improved for patients who receive care from collaborative teams over individual clinicians. Outcomes are even better when team members interact regularly and share a team vision. Disjointed teamwork and poor collaboration and communication between physicians and nurse practitioners are often contributing factors when patient care suffers.
It’s a known fact that team-delivered care is better for patients, but studies like this one also demonstrate exactly what factors within primary care practices affect teamwork. The study found that team-delivered care is best achieved when NP’s ability to deliver care independently is encouraged and when NPs perceive they are viewed and treated by administrators as integral members of care teams.
Questions from the questionnaire to measure autonomy and independent practice, relationships with administration, and teamwork for nurse practitioners included:
- NPs do not have to discuss every patient care detail with a physician.
- My organization creates an environment for NPs to practice independently.
- Administrators are open to nurse practitioners’ ideas on improving patient care.
- Administrators share information equally with nurse practitioners and physicians.
- NPs feel valued by physicians.
- Nurse practitioners and physicians collaborate to provide patient care.
- Physicians support nurse practitioners’ patient care decisions.
Nurse practitioners who participated in the study were instructed to rate their responses to the questions using a four-point scale of “1,” strongly disagree; “2,” disagree; “3,” agree; and “4,” strongly agree. The study supported previous findings from other studies encouraging administrators to promote teamwork between physicians and nurse practitioners.
The paper for this study is titled “Nurse Practitioner Autonomy and Relationships with Leadership Affect Teamwork in Primary Care Practices: A Cross-Sectional Survey.” The paper will appear in the July issue of Journal of General Internal Medicine.
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