Influence of Practice Environment and Manager Leadership Style on Interprofessional Collaboration and Quality of Care in Acute Care Nurse Practitioners.

Abstract

Background: Over 90% of nurse practitioners (NPs) are employed in hospitals in Taiwan. The influence of different practice environments and manager leadership styles on NP interprofessional collaboration and quality of care in acute care hospitals has been inadequately studied.

Purpose: This study was designed to investigate the influence of practice environment and leadership style on NP interprofessional collaboration and the quality of care they provide in acute care settings.

Methods: A cross-sectional design and a national online survey were employed to collect data from 1,198 NPs who are members of the Taiwan Association of Nurse Practitioners (TANP). The measures utilized in this study include the Nurse Practitioner Acute Care Organizational Climate Questionnaire, the Multifactor Leadership Questionnaire-Form 6S, and the Provider-Perceptions of Team Effectiveness Questionnaire (Provider-PTE). A multiple regression model was applied to identify the factors potentially associated with interprofessional collaboration and quality of care.

Results: Physician relations and professional visibility were identified as the two most critical factors within the practice environment, enhancing interprofessional collaboration and quality of care, and "management with expectation" was identified as a key leadership strategy for improving both outcomes. These three factors accounted for 44.8% and 30.6% of the respective variances in NP interprofessional collaboration and quality of care.

Conclusions/implications for practice: Improving practice-environment factors such as relationship with physicians and professional visibility, as well as managing NPs using an expectations-based leadership style, offer the potential to significantly enhance NP interprofessional collaboration and the quality of care they provide. Health care organizations may consider developing policies that focus on improving the practice environment as well as implementing transactional leadership styles to promote NP interprofessional collaboration and the quality of care they provide.