Interdisciplinary Communication and Collaboration Among Physicians, Nurses, and Unlicensed Assistive Personnel
Abstract
Purpose: Historically, health care has primarily focused on physician, nurse, and allied healthcare provider triads. Using a phenomenological approach, this study explores the potential for hospital‐based interdisciplinary care provided by physicians, nurses, and unlicensed assistive personnel (UAPs). Design: This phenomenological study used a purposive nonprobability, criterion‐based, convenience sample from a metropolitan hospital. Theoretical Foundation: Malhotra's (1981) Schutzian lifeworld phenomenological orchestra study provided the theoretical basis for the conductorless orchestra model, which guided this study. In an orchestra, each member sees and hears the musical score from a different vantage point or perspective and has a different stock of knowledge or talent; however, members work together to produce a cohesive performance. Like the orchestra, individual talents and perspectives of physicians, nurses, and UAPs can be collaboratively blended to create a symphony: enhanced patient‐centered care. Methods: Qualitative semistructured face‐to‐face, individual interviews were carefully transcribed and coded with the aid of NVivo 9, a qualitative data analysis software program, to discover emergent patterns and themes. Findings: The study suggests that most of the time physicians, nurses, and UAPs operate as separate healthcare providers who barely speak to each other. Physicians see themselves as the primary patient care decision makers. Many physicians acknowledge the importance of nurses’ knowledge and expertise. On the other hand, the study indicates a hierarchical, subservient relationship among nurses and UAPs. Physicians and nurses tend to work together or consult each other at times, but UAPs are rarely included in any type of meaningful patient discussion. Conclusions: Since physicians, nurses, and UAPs each provide portions of patient care, coordination of the various treatments and interventions provided is critical to prevent errors and fragmentation of care. Tensions, misunderstandings, and conflicts caused by differences of opinions and interests can interfere with effective interdisciplinary communications and collaboration. Improving patient safety in the hospital requires addressing the current hierarchical professional structure inherent in healthcare delivery. A hospital patient care model based on the conductorless orchestra model would mitigate hierarchy; recognize physician, nurse, and UAP contributions to care; promote improved communication and collaboration; and enhance patient safety. Clinical Relevance: Study results provide additional information supporting interdisciplinary communication and collaboration education and training among physicians, nurses, and UAPs to support positive patient care outcomes.
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Patient care has been found to be compromised when nurses and doctors work in isolation to each other with ineffective communication, especially within hierarchical authority structures where clinicians are seen as the primary clinical decision-maker for a patient.
“Patient care has been found to be compromised when nurses and doctors work in isolation to each other with ineffective communication with each other, especially within hierarchical authority structures where clinicians are seen as the primary clinical decision-maker for a patient [30,31].”
From Barriers and enablers of implementing bubble Continuous Positive Airway Pressure (CPAP): Perspectives of health professionals in Malawi (2020) · cites this paper as [30]
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- Authors
- Lancaster, G., Kolakowsky‐Hayner, S., Kovacich, J., & Greer‐Williams, N.
- Affiliations
- Assistant Nursing Care Coordinator, <i>Omicron Delta</i> Mount Sinai St. Luke's Hospital New York NY
- Santa Clara Valley Medical Center (US)
- University of Phoenix (US)
- University of Arkansas for Medical Sciences (US)
- Venue
- Journal of Nursing Scholarship
- Publisher
- Wiley
- Published
- 2015-03-19
- Volume
- 47
- Issue
- 3
- Pages
- 275-284
- ISSN
- 0363-2792 (ISSN-L)
- 1527-6546
- 1547-5069
- OpenAlex
- W1935857750
- Cited by
- 229
- References
- 47
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 25 · 2023: 21 · 2022: 20 · 2021: 45 · 2020: 15 · 2019: 22 · 2018: 18 · 2017: 24 · 2016: 11 · 2015: 2
- FWCI
- 33.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Nursing Scholarship (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Health Professions › General Health Professions › Interprofessional Education and Collaboration
- Health Sciences › Nursing › Research and Theory › Nursing education and management
- Health Sciences › Health Professions › General Health Professions › Nursing Roles and Practices
- Keywords
- interdisciplinary communication, interdisciplinary collaboration, unlicensed assistive personnel, nurse-physician relationship, hospital care teams, hierarchy in healthcare, patient safety, patient-centered care, care fragmentation
- MeSH terms
- Adult, Attitude of Health Personnel, Communication Barriers, Cooperative Behavior, Decision Making, Female, Humans, Male, Medical Staff, Hospital, Middle Aged, Nurses, Patient Care Team, Surveys and Questionnaires, Physician-Nurse Relations, Professional Role, Interdisciplinary Communication, Qualitative Research
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