similar accountability expectations and
have closer working relationships than
when the nurses are employees, but the
physicians are not. As one hospital CEO
said, “We have a closed medical staff, and
so our physicians have more time to do
quality work. We are lucky because they
provide support for our nurses. This is not
the case for all community hospitals. In
community hospitals that have a voluntary
medical staff, the nurses have to support
the physicians’ quality work because the
physicians are volunteers. So, people prop
them up more, and nurses are expected
to do it all for them.” Many respondents
advocated that strong physician-nurse
partnerships are essential to achieving
quality improvement and sustaining the
accomplishments.