What is the Value of Doctors and Nurses Working Together?

NPA Values Challenge: “Medicine can be scary because we have such power to do harm […] but in a culture of teamwork, you feel like everyone has got your back.”

In “When Doctors and Nurses Work Together,” Pauline Chen, MD explores the added value of care coordination between doctors and nurses in U.S. health care settings.

Is there really a specter of malpractice and mistakes that can be vanquished with care coordination between healthcare providers? If care coordination can improve patient outcomes, physician satisfaction and reduce malpractice costs, why isn’t care coordination and integrated care the new normal? What are the barriers to adopting this practice across practices and hospitals? These questions are at the heart of the care coordination proposal included in NPA’s new policy brief, Value and Values in Health Care.

Read Dr. Chen’s article below and tell us what you think. Your responses to NPA blog posts help us refine our communications about important issues and influence the choice of initiatives we undertake.

A group of doctors at Yale-New Haven Hospital has been quietly working to change the culture of “defensive medicine” that so many have come to accept as inevitable. To foster greater interdisciplinary understanding, they [the program] required obstetricians beginning their training to shadow nurses for a day or two to learn about their work challenges. Most important, they hired a nurse to lead the safety program. Her responsibilities included overseeing the training sessions, meeting regularly with providers for feedback, and working with the safety committee to evaluate patient outcomes. The changes resulted in a significant decrease in the number of adverse patient outcomes, like traumatic birth injuries, admissions to the intensive care unit and death. But leaders of the initiative also discovered that their changes had had a dramatic effect on malpractice suits. The number of liability claims against obstetricians in the Yale department dropped more than 50 percent. And while the values of malpractice claims awarded or settled in Connecticut continued to rise, Yale’s obstetric liability payments fell by 95 percent, a saving of almost $50 million over a five-year period.

For the full article, click here.