{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T10:19:07Z","timestamp":1787653147847,"version":"build-2736575974"},"reference-count":28,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["K01HL171466"],"award-info":[{"award-number":["K01HL171466"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL146386"],"award-info":[{"award-number":["R01HL146386"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Services Research"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Expanding on previous research applying value\u2010added modeling to clinician performance measurement, we quantified simultaneous nurse and physician performance among mechanically ventilated patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Setting and Design<\/jats:title>\n                    <jats:p>In a retrospective cohort spanning five academic hospitals, we used multiple linear regression to determine relationships between nurse and physician assignments and changes in patient illness severity (Laboratory\u2010based Acute Physiology Score) during intensive care unit (ICU) admission. Individual clinician performance was derived from regression coefficients. Collective clinician contribution to disease severity variance was assessed by comparing the coefficient of determination across clinician\u2010only and joint\u2010clinician models. Consistency of clinician performance estimates was cross\u2010validated using random 1:1 partitions of the patient population using Pearson's correlation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources and Analytic Sample<\/jats:title>\n                    <jats:p>Electronic health record data were extracted from mechanically ventilated patients at study ICUs between 2018 and 2022.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Principal Findings<\/jats:title>\n                    <jats:p>\n                      Among 17,082 clinical encounters, 215 physicians, and 1719 nurses, nurse and physician assignments improved model fit. Together, they attributed 7% of variability in disease severity trajectory; separately, nurse assignments accounted for greater variance than physician assignments (6% vs. 4%, respectively). Cross\u2010partition clinician performance was moderately correlated (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.31 [nurses]\n                      <jats:italic>, r<\/jats:italic>\n                      \u2009=\u20090.4 [physicians],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001 for both comparisons).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Individual nurse and physician care independently contribute to disease severity trajectory among mechanically ventilated patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1475-6773.70153","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T10:09:49Z","timestamp":1785319789000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quantifying Nurse and Physician Clinical Performance for Mechanically Ventilated Patients"],"prefix":"10.1111","volume":"61","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7921-1879","authenticated-orcid":false,"given":"Christopher F.","family":"Chesley","sequence":"first","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care, Palliative and Advanced Illness Research (PAIR) Center, Department of Medicine, Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7187-1511","authenticated-orcid":false,"given":"Yingying","family":"Lu","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9373-5035","authenticated-orcid":false,"given":"Rachel","family":"Kohn","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care, Palliative and Advanced Illness Research (PAIR) Center, Department of Medicine, Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7360-2489","authenticated-orcid":false,"given":"Hayley B.","family":"Gershengorn","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Critical Care, and Sleep Medicine University of Miami Miller School of Medicine  Miami Florida USA"},{"name":"Division of Critical Care Medicine Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7450-3717","authenticated-orcid":false,"given":"Kelly C.","family":"Vranas","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, &amp; Critical Care Medicine Oregon Health &amp; Science University  Portland Oregon USA"},{"name":"Center to Improve Veteran Involvement in Care and Section of Pulmonary &amp; Critical Care Medicine VA Portland Health Care System  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine L.","family":"Hough","sequence":"additional","affiliation":[{"name":"Department of Medicine Oregon Health &amp; Science University  Portland Oregon USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5501-1397","authenticated-orcid":false,"given":"Olga","family":"Yakusheva","sequence":"additional","affiliation":[{"name":"School of Nursing Johns Hopkins University  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7776-5349","authenticated-orcid":false,"given":"Deena Kelly","family":"Costa","sequence":"additional","affiliation":[{"name":"Yale School of Nursing Yale University  New Haven Connecticut USA"},{"name":"Section of Pulmonary, Critical Care and Sleep Medicine Yale School of Medicine  New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7104-5682","authenticated-orcid":false,"given":"Deanna J.","family":"Marriott","sequence":"additional","affiliation":[{"name":"School of Nursing University of Michigan  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7970-286X","authenticated-orcid":false,"given":"David A.","family":"Asch","sequence":"additional","affiliation":[{"name":"Leonard Davis Institute of Health Economics, The Wharton School, Division of General Internal Medicine University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-0599-1134","authenticated-orcid":false,"given":"Aerielle","family":"Belk","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Scott","sequence":"additional","affiliation":[{"name":"Palliative and Advanced Illness Research (PAIR) Center University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Wang","sequence":"additional","affiliation":[{"name":"The Parity Center University of Pennsylvania Perelman School of Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3239-1443","authenticated-orcid":false,"given":"Meeta","family":"Kerlin","sequence":"additional","affiliation":[{"name":"Division of Pulmonary, Allergy, and Critical Care, Palliative and Advanced Illness Research (PAIR) Center, Department of Medicine, Leonard Davis Institute of Health Economics University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201607-579OC"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002578"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000000978"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1037\/amp0000247"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-104-3-410"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.521"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202310-1971OC"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202210-1975ED"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1513\/AnnalsATS.201711-867OC"},{"key":"e_1_2_11_11_1","first-page":"18","article-title":"The Association Between Interdisciplinary Collaboration and Patient Outcomes in a Medical Intensive Care Unit","volume":"21","author":"Baggs J. 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