Azzi, Helena E.

Rapid social and economic changes are modifying health care delivery systems and health care financing. These changes require that primary care physicians develop new collaborative approaches to patient care, including a reassessment of relationships with other primary care providers, particularly nurse practitioners. The purpose of this research was to explore and define what constitutes a successful collaborative practice. Open-ended, interactive interviews were conducted with three dyads of physician - nurse practitioner in the ambulatory care setting. Data analysis using the grounded theory method revealed six key elements associated with effective collaborative practice: Communication, competence, autonomy, coordination, trust and personality. This research contributes to clarification of the barriers that hinder a collaborative practice and suggests many benefits derived from such a practice. The findings of the study may inspire other health care providers to enter a collaborative practice to achieve excellence in patient care. Ethical decisions cannot be achieved by a single care provider, but rather require the expertise and unique abilities of both physician and nurse practitioner.