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The Collaborative Practice was a demonstration project sponsored by the Hartford Hospital Administration, and the Departments of Medicine and Nursing. A prospective evaluative study was established to measure the impact of collaborative practice on increased patient and family satisfaction with health care, as well as the impact on selected outcome variables. A specific 27-bed medical unit and a comparison unit with identical structural characteristics were chosen for study from March 31, 1982, to March 31, 1983. Results of the study indicate that significant differences in patients' perceptions of care existed between the Collaborative Practice Unit (CPU) and the comparison unit under a traditional team nursing system. More positive ratings from patients on the CPU were found for all selected dimensions: patient-provider interaction; quality of care; health education; knowledge of practitioners; and the environment. In order to assess the impact of collaborative practice on outcome variables, a retrospective audit of randomly selected patient records was done. No significant differences for selected variables were found except for the number of health teaching plans. More documented health teaching was recorded on the Team Nursing Unit.

Cost containment, increased severity of illness, earlier patient discharge, and high staff turnover are causing nurse executives to implement new systems of health care delivery. One such delivery system, collaborative practice, strives to maximize efficient and effective use of staff, to improve nurse retention, and to enhance patient care. The authors present one approach to implementing collaborative practice and the empirical findings related to the system's impact on physician-nurse professionalism.