Sharon A. Bridges

Exploration of the concept of collaboration within the context of nurse practitioner‐physician collaborative practice

Purpose: Collaboration in the healthcare setting is a multifaceted process that calls for deliberate knowledge sharing and mutual accountability for patient care. The purpose of this analysis is to offer an increased understanding of the concept of collaboration within the context of nurse practitioner (NP)‐physician (MD) collaborative practice. Data sources: The evolutionary method of concept analysis was utilized to explore the concept of collaboration. The process of literature retrieval and data collection was discussed. The search of several nursing and medicine databases resulted in 31 articles, including 17 qualitative and quantitative studies, which met criteria for inclusion in the concept analysis. Conclusions: Collaboration is a complex, sophisticated process that requires commitment of all parties involved. The data analysis identified the surrogate and related terms, antecedents, attributes, and consequences of collaboration within the selected context, which were recognized by major themes presented in the literature and these were discussed. An operational definition was proposed. Implications for practice: Increasing collaborative efforts among NPs and MDs may reduce hospital length of stays and healthcare costs, while enhancing professional relationships. Further research is needed to evaluate collaboration and collaborative efforts within the context of NP‐MD collaborative practice.Purpose Collaboration in the healthcare setting is a multifaceted process that calls for deliberate knowledge sharing and mutual accountability for patient care. The purpose of this analysis is to offer an increased understanding of the concept of collaboration within the context of nurse practitioner (NP)-physician (MD) collaborative practice. Data sources The evolutionary method of concept analysis was utilized to explore the concept of collaboration. The process of literature retrieval and data collection was discussed. The search of several nursing and medicine databases resulted in 31 articles, including 17 qualitative and quantitative studies, which met criteria for inclusion in the concept analysis. Conclusions Collaboration is a complex, sophisticated process that requires commitment of all parties involved. The data analysis identified the surrogate and related terms, antecedents, attributes, and consequences of collaboration within the selected context, which were recognized by major themes presented in the literature and these were discussed. An operational definition was proposed. Implications for practice Increasing collaborative efforts among NPs and MDs may reduce hospital length of stays and healthcare costs, while enhancing professional relationships. Further research is needed to evaluate collaboration and collaborative efforts within the context of NP-MD collaborative practice.

Duplicated Laboratory Tests: A Hospital Audit

To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

Duplicated Laboratory Tests: Evaluation of a Computerized Alert Intervention Abstract

Abstract: Redundant testing contributes to reductions in healthcare system efficiency. The purpose of this study was to: (1) determine if the use of a computerized alert would reduce the number and cost of duplicated Acute Hepatitis Profile (AHP) laboratory tests and (2) assess what patient, test, and system factors were associated with duplication. This study used a quasi‐experimental pre‐ and post‐test design to determine the proportion of duplication of the AHP test before and after implementation of a computerized alert intervention. The AHP test was duplicated if the test was requested again within 15 days of the initial test being performed and the result present in the medical record. The intervention consisted of a computerized alert (pop‐up window) that indicated to the clinician that the test had recently been ordered. A total of 674 AHP tests were performed in the pre‐intervention period and 692 in the postintervention group. In the pre‐intervention period, 53 (7.9%) were duplicated and in postintervention, 18 (2.6%) were duplicated (p < .001). The implementation of the alert was shown to significantly reduce associated costs of duplicated AHP tests (p ≤ .001). Implementation of computerized alerts may be useful in reducing duplicate laboratory tests and improving healthcare system efficiency.

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …

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To the Editor: Rising healthcare costs are unlikely to be sustainable in the current healthcare environment. Reducing costs is a major effort of governments and policymakers (1). One component of these costs is the wide range and overwhelming number of diagnostic tests (2). Laboratory testing of hospitalized patients can be redundant when multiple providers order the same or similar tests for the same patient, contributing needlessly to the total healthcare costs (3–5). We evaluated the frequency of duplicate ordering of 6 in-house laboratory tests (Table 1) in hospitalized patients over a 12-month period and analyzed the costs associated with this practice. Research questions for this study included the following: ( a ) In this sample of hospitalized patients, what was the prevalence of duplication of the selected laboratory tests over twelve months, and ( b ) what were the costs associated with duplication of these laboratory tests? View this table: Table 1. Costs and ordering patterns for 6 selected tests. A retrospective descriptive design was used to evaluate the prevalence that selected tests were duplicated. We chose these 6 tests because a medical need to have 2 results for these tests during …