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A Summary of the October 2009 Forum on the Future of Nursing Acute Care (2010) / Chapter Skim
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5 Interdisciplinary Collaboration
Pages 35-42

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From page 35...
... Nevertheless, this study, and several others conducted over the years, showed that a positive work environment led to greater retention of registered nurses (RNs) because they developed a sense of having a greater influence over the working environment, more collaboration with physicians and other health care workers, and access to a wider variety of conflict resolution skills.
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From page 36...
... . Together, this research contributed to a recommendation made in 2003 at a summit sponsored by the Institute of Medicine that health professions education should focus on core competencies for all health professionals so they can work in interdisciplinary teams, use evidence-based practice, provide patient-centered care, apply quality improvement principles, and use information technologies, as shown in Figure 5-1 (IOM, 2003)
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From page 37...
... In addition, a culture of collaboration, strong personal relationships, and time and flexibility are needed to make programs work. Mitchell offered a single recommendation: Academic institutions and health care organizations need to make a real commitment to interprofessional education that develops and sustains collaborative skills, both before and after licensure.
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From page 38...
... Rosenstein defined disruptive behavior as "any inappropriate behavior, confrontation, or conflict ranging from verbal abuse to physical or sexual harassment." Disruptive behavior in the workplace is a serious concern for those who experience it and witness it, as well as for the patients being cared for in this negative environment. As demonstrated in Figure 5-2, there is relatively little physical abuse, Rosenstein said, but there is "a lot of yelling, a lot of screaming, a lot of condescending, berating behavior, particularly in front of peers." Yelling/Raising Voice Disrespectful Interaction Abusive Language Berating in Front of Peers Condescension Insults Abusive Anger Berating in Front of Patients Berating in Private Physical Abuse Other 0 20 40 60 80 100 Percentage FIGURE 5-2 Types of disruptive behaviors witnessed by respondents.
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From page 39...
... Furthermore, surveys done by Rosenstein and his collaborators document a link between disruptive behavior and undesirable clinical outcomes, including adverse events, errors, increased mortality, and decreased patient safety, quality of care, and patient satisfaction, as shown in Figure 5-3. Among all personnel surveyed, 18 percent were aware of specific adverse effects that occurred as a result of disruptive behavior.
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From page 40...
... As a result the patient died. The doctor chose to undo all the help that various staff had been working on for weeks to get this patient the help so badly needed." Many factors cause people to act and react the way they do in these situations, including age differences, gender, culture, ethnicity, values, experiences, training, and personality styles.
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From page 41...
... People need to work through problems together, often with the aid of a coach or facilitator. In response to a question about whether an age and gender gap between physicians and nurses contributes to a lack of collaboration and whether narrowing that gap will change matters, Rosenstein responded that an "old guard" still exists in health care that has been doing business the same way for many years.
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From page 42...
... 42 FORUM ON THE FUTURE OF NURSING: ACUTE CARE team during their training. "They are going to need to do that, and they are the clinical leaders, so I think it is a critical part of their education." Finally, a viewer of the webcast commented that multidisciplinary education should include not just physicians and nurses, but hospital and health care administrators as well.
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Key Terms

  • patient safety
  • quality improvement
  • acute care
  • interdisciplinary collaboration
  • interprofessional education

  • patient satisfaction
  • clinical outcomes
  • positive work
  • disruptive behaviors
  • witnessed disruptive

  • reduce disruptive
  • including nurses
  • work environment
  • care team
  • entire respondent

  • vha west
  • administrative executives
  • interprofessional collaboration
  • west coast
  • undesirable clinical

  • continuous quality
  • results shown
  • defined disruptive
  • disruptive events
  • health professions

  • health professionals
  • critical care
  • care reform
  • factors cause
  • ongoing acquisition


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