• Dana Tschannen and Beatrice J Kalisch.
• Nursing Business andHealth Systems, University of Michigan, Ann Arbor, MI, USA. djvs@umich.edu
• J Nurs Manag. 2009 Nov 1; 17 (7): 796-803.

AimThis study examines the relationship between nurse/physician collaboration and patient length of stay (LOS).BackgroundThe quality of nurse/physician relationships has been shown to have an impact on patient outcomes. As the acuity level of patients admitted to hospitals continue to rise, the need for collaboratively determined care is essential for avoiding errors and promoting quality.MethodsData were collected on four units located in two Midwest hospitals. Nurses (n = 135) were asked to complete a survey seeking perceptions of nurse/physician collaboration. The survey data were then linked with patient (n = 310) data, including LOS, diagnostic-related groups (DRG) category and other patient-specific characteristics.ResultsPerceptions of nurse/physician collaboration were positively linked with actual LOS (P < 0.001) and inversely related to deviation from expected LOS (i.e. patient stay longer than expected) (P < 0.01). Patients receiving care from nurses who perceived greater collaboration were elderly and had higher levels of acuity. Longer LOS for these patients may be a result of their higher acuity level.Conclusions And Implications For Nursing ManagementThis study found that collaboratively determined care may result in longer LOS, but could prevent complications that may otherwise go untreated. Nurse administrators must implement strategies that foster the development of nurse/physician collaboration.

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