The responsibilities of nurses, physicians, pharmacists, and other members of the clinical care team are certainly different, but none is more or less important to patient care.
The importance of interdisciplinary care cannot be overstated. Over the last seven years, the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI) has funded 40 studies to investigate how nurses contribute to and can improve patient care quality. The findings confirm the link between nursing and quality of care.
Of course, as in most endeavors, there's room for improvement. Earlier this year, I wrote that it's time to "upend the hospital hierarchy." I argued that "the current top-down structure of patient care—where power starts with physicians and flows down to nurses—is flawed."
Instead of this top-down hierarchy, I believe all branches of healthcare should function as equals. The responsibilities of nurses, physicians, pharmacists, and other members of the clinical care team are certainly different, but none is more or less important to patient care. All members of the team are needed for their own, particular skills.
Nowhere is this mentality more vital than within interdisciplinary care.
"It's respect; mutual respect for the individual providers," says Angela D. Saathoff, BS, RN, MSN, CNP. "It is important to utilize everyone's skills and provide respect for that."
Saathoff is a case-in-point: She's a nurse practitioner who has worked with Project IMPACT: Diabetes [PDF], a national research initiative in which nurses, pharmacists, physicians, and diabetes educators work together as part of an interdisciplinary care team to care for people with diabetes.
The nationwide program has cared for more than 2,000 patients who were uninsured, under-insured, homeless and/or living below the poverty line in 25 communities. Interim data released in October shows statistically significant decreases in participants' A1C, LDL cholesterol, systolic blood pressure, and BMI.
Continual Attention to Patients
Saathoff is on staff at a Diabetes Care Group, a diabetes-only physician practice based in Jackson, MS, which partnered with pharmacists from the University of Mississippi School of Pharmacy for the diabetes project.
She says interdisciplinary care is part of the patient experience from the moment appointments at DCG begin. For instance, she says rather than simply triaging patients and delivering follow-up care at the beginning or end of appointments, nurses are involved with patients right from the start and continually throughout patient visits,
"The setup at Diabetes Care Group is unique in that it is interdisciplinary in every way," Saathoff says. "We have got a team of educators and providers working together to take care of the patient."
She says the providers meet with patients in groups, too. Every visit includes a 15–20 minutes of education and a chance for the patient to talk with the team about any concerns.
Do Personal Ties Matter?
Listening to Saathoff talk about her colleagues and the tremendous amount of respect they have for each other, I wondered how much of that was simply because they all got along on a personal level. After all, it's much easier to work as a team when you're all friends, too. So I asked Saathoff whether providers' personalities need to mesh well in order for interdisciplinary care to truly work.
"No, I don't believe so," she says. "[With] a lot of the personal aspect of work you just have to leave it off the table. You're there to take care of the patient and your personal feelings should not be involved."
Still, whether or not individual members like each other or even get along personally, Saathoff again emphasizes that respect is something that is needed. And part of that is realizing that each member of the care team, including nurses, brings their own unique perspective, experience, and training to the table.
"They may be able to find a way to get through to the patient that a provider might not think of," Saathoff says. "It's very important to utilize that…Your nursing staff is just essential to good care."
Alexandra Wilson Pecci is an editor for HealthLeaders.
