To quote Henry Ford: "Coming together is a beginning. Keeping together is progress. Working together is success." This applies to the relationship between nurse and physician leaders, especially in today's cath labs. The days of nurses and physicians staying in their own silos can no longer be sustained. By Beth Oliver, RN
At Mount Sinai Heart in New York City, the vision of Samin Sharma, MD, of a true partnership between nurses and physicians has not only been realized, but has produced excellent outcomes. Our cardiac cath lab has the lowest risk-adjusted mortality rates and one of the highest patient satisfaction rates in the Mount Sinai Medical Center.
The cath lab performed over 5,800 adult cardiac interventions in 2009, yet had the lowest complication rate in the country. The system of established standards protocols, rigorous attention to detail and a strong sense of teamwork has helped achieve the best interventional outcomes. In our cath lab, all staff are included in the team.
A successful physician–nurse partnership exists when leaders from both sides are in agreement with the mission and the goals of the service. And the partnership exists on a daily basis, not merely for show or special projects.
Professional relationships between the two disciplines have evolved over the years. In the 1960s and 1970s, nurses assumed more of a subservient role in the nurse-doctor relationship. In the 1980s, the focus was on interdisciplinary teamwork between all healthcare providers, especially between doctors and nurses.
Studies in the 1990s showed that collaboration significantly correlated with positive patient outcomes (Heart and Lung 1992;21:18-24). In fact, the Institute of Medicine clearly demonstrated that when healthcare professionals understand each other's roles and are able to collaborate, patients are more likely to receive safe, quality care (IOM, Health Professions Education: A Bridge to Quality, 2003).
Studies done by the American Nurses Credentialing Center also have shown that a positive correlation between physician-nurse collaboration results in quality patient outcomes in magnet hospitals (Western J Nurs Res 2003;35:434-452).
In 2004, the Joint Commission stated that the nurse executive should participate actively in hospital leadership functions and collaborate with other hospital leaders in organizational performance improvement. With all the attention on regulatory standards and competition for the best quality outcomes among institutions, partnerships are essential in today's healthcare environment for communicating, exchanging ideas and maintaining quality outcomes.
To remain competitive, partnerships between nurses and physicians are essential because they ensure equal responsibility for patient outcomes, true collaborative interdisciplinary work, patient safety and quality, and staff and patient satisfaction.
The benefits of running a cath lab as a partnership are multiple. Our cath lab is very protocol driven, which allows us to maintain the highest quality and safety. Everyone knows they are on the same team with the same purpose. In addition, all cath lab staff members attend weekly in-services, which keep them apprised of new technology, as well as support interprofessional education.
Our cardiac service line is successful because it invests in human capital. It is transparent and has a strategy that embraces social purposes, develops employee competencies and holds its leaders accountable. Employees feel they have worth and that what they do has an impact.
With a strong partnership and congruent vision, the mission can be achieved. Our mission in the cath lab is to deliver the highest quality of diagnostic and interventional cardiac care through teamwork, procedural excellence and innovations. Through the successful collaboration and partnership of nurses and physicians, the Mount Sinai Heart cath lab has realized its mission.
Ms. Oliver is the senior nursing director of Mount Sinai Heart in New York City.