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Texas RNs and physicians establish culture of collaboration

Initiating policies and modeling professional behavior help facilities move forward

Monday April 7, 2014
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Across Texas, RNs and physicians are proving that respectful communication often leads to improved patient outcomes. How is this achieved? By establishing a culture of collaboration. While implementing successful collaborations is a work-in-progress, several facilities are initiating policies, councils and modeling professional behavior.


Patricia Duran, RN
El Paso

At the Sierra Providence East Medical Center in El Paso, CNO Patricia Duran, RN, DNP, CENP, Upper Rio Grande Region Texas Team co-leader, said mutual respect makes the difference.

“Speaking to professional practice, deliberately, on purpose, and modeling the professional behavior with physicians, has helped us create a culture of collaboration,” Duran said. “Although some physicians still act and speak inappropriately to nurses and to each other at times, we hold them accountable to the Disruptive Physician Policy.”

As a member of the ‘A-Team,’ also called the ‘C-Suite’ [CEO, COO, CNO, CFO], Duran said it is not uncommon for her to speak to a physician who has been disruptive, or has made a disparaging remark toward a nurse, the facility or another physician.

“If it continues, the medical staff rules and regulations process is applied where our chief of staff sits with the physician and reviews expectations of behavior,” she said.

Texas Team information

The Texas Team is a statewide Campaign for Action coalition consisting of business, education and community groups. It s led by an executive committee of RNs, representing eight regions in Texas.

The coalition serves to ensure nurses are full partners with physicians and other healthcare professionals in redesigning healthcare in the U.S., per a recommendation of the Institute
of Medicine.


Jane McCurley, RN
North Austin

At St. David’s North Austin Medical Center, CNO Jane McCurley, RN, DNP, MBA,NEA-BC, FACHE, co-leader Central Texas Region, said the value of respect and excellence builds the infrastructure for successful collaboration.

“Our culture is one of collaboration and interdisciplinary focus on improving patient outcomes,” McCurley said.

Nurse physician partnerships are often established over time after RNs routinely join a specific physician on rounds, according to McCurley. Also, an annual physician satisfaction survey shows a positive trend in nursing quality and on how physicians and other executive team members respond to nurses. One venue is in critical care, where a nurse, physician and other clinicians collaborate on the patient plan of care daily, McCurley said.

“The rounding is [used] to develop an interpersonal relationship, determine what is working well, if [nurses] have the tools and equipment to do their jobs, and to improve any systems/processes within our control,” she said.

Tyler

In Tyler, the Trinity Mother Frances Hospital, and Louis and Peaches Owen Heart Hospital created an integrated the ‘Trinity Chief Model’ to strengthen collaborations, according to Senior Vice President/System and CNO Robert Rose, RN, MS, NEA-BC; co-leader, East Texas Region.

“We monitor our RN/MD relationships through yearly nursing satisfaction surveys, which has a category for RN/MD collaboration,” Rose said. “We apply the scores to develop action plans and communicate to our nurses and physicians.”

While successful collaboration to improve patient outcomes means cultivating new ways of working together, the future of nursing with respect to the overall healthcare industry will require even
more initiatives.


Julie Thomas, RN
Moving forward

“Going forward, efforts for collaboration must move beyond the traditional setting, such as the ‘brick and mortar’ of acute care hospitals, and into community settings,” said Julie Thomas, RN, DNP, CPHQ, NEA-BC, region leader, North Texas. “As healthcare increasingly shifts toward the Affordable Care Act provisions, nurses must position themselves firmly as partners in the healthcare provider network. Only through successful collaboration will we move from a ‘disease treatmet system’ to a true
healthcare system.”

Tips for successful RN-physician collaborations

These suggestions, from CNOs throughout Texas, may help other nurses establish strong collaboration with their physician counterparts.
1. Develop a strong CNO and CMO partnership to drive organizational performance.
2. Implement a culture of accountability to address issues and concerns in a timely and non-retaliatory environment.
3. Align teamwork and communication of all stakeholders for optimum patient safety.
4. Establish and promote a purposeful culture of respectful communications.
5. Measure the perception of your medical and nursing staff collaboration; then work together to design specific tactics to increase collaborations.
6. Take command of the literature and be willing to transform professional practices.
7. Create a willingness to review and discuss research/evidence-based practice with the medical staff.
8. Cultivate a physician champion.
9. Generate an awareness of the role nurses play in professional practice, and the contributions nurses provide to the environment.
10. Let it be known that respectful communication is an important, necessary aspect of professionalism and collaboration.


Amy Gallagher is a freelance writer. Post a comment below or email editorSouth@nurse.com.