Learning Objective #1: Apply traditional roles of the clinical nurse specialist to promote continuity of care

Learning Objective #2: Define outcome measures for collaborative practice between clinical nurse specialists

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Collaboration between healthcare providers has shown to positively impact patient outcomes. Much of the literature describes collaboration between physicians and nurses or other providers. This presentation will describe the unique collaborative practice between two clinical nurse specialists within the same health system. The purpose of this presentation is to describe the roles of the CNS in the acute and subacute settings within the context of a conceptual model of CNS practice and to describe how their collaborative practice influenced patient care in two settings and across the healthcare continuum. Esophagectomy surgery patients are a complex patient population whose postoperative care may require an extended stay in a subacute care setting before their discharge home. A collaborative practice model was established between the thoracic acute care clinical nurse specialist (CNS) and the subacute CNS in an effort to optimize care, reinforce education, assist in the transition to subacute and subsequently to home, and to prevent readmission back to the acute care setting. Although this complex patient population is used to demonstrate the effects of a collaborative practice, this model of practice can be applied to any patient population and across any level of care. Three years of data was collected. The result of our collaboration was a decrease in the average length of stay in both settings, a decrease in the number of readmissions back to the acute care hospital from the subacute care setting, and a decrease in the average direct cost per admission in both settings.