Characterizing Teamwork in Cardiovascular Care Outcomes: A Network Analytics Approach.
Characterizing Teamwork in Cardiovascular Care Outcomes: A Network Analytics Approach.
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DOI：
10.1161/circoutcomes.116.003041
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发表时间：
2016-11
期刊：
影响因子：
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通讯作者：
Soulakis ND
中科院分区：
文献类型：
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作者：
Carson MB;Scholtens DM;Frailey CN;Gravenor SJ;Powell ES;Wang AY;Kricke GS;Ahmad FS;Mutharasan RK;Soulakis ND
医疗保健团队合作的性质是复杂的和跨学科的，基于共享的患者接触的提供者合作对其成功至关重要。表征强度的工作关系与风险调整后的病人的结果提供了深入了解提供者在医院环境中的相互作用。我们从西北医学的企业数据仓库中提取了四年的患者，提供者和活动数据，用于在住院心脏病学单位中遇到。然后，我们创建了一个提供者-患者网络，以确定共同参与患者接触的医疗保健提供者，并计算提供者-提供者对的满意度。我们展示了一个新参数的应用，共享的积极成果比（SPOR），一个客观的复合指标，量化一组共享患者的积极成果的浓度。我们将观察到的334个提供者和3，453个关系的合作网络与基于随机结果的SPOR评分的1，000个网络进行了比较，发现提供者对之间的188个合作关系显着高于预期的患者满意度。一组22个供应商在病人满意度方面表现出色。我们的研究结果表明，整个网络的协作得分具有很高的变异性，并突出了我们在一组共享患者接触中识别出高于和低于预期得分的关系的能力。不同的供应商团队的满意度似乎各不相同。团队协作可以使用跨提供者对的协作的复合度量来量化。在足够的一组共享遭遇中跟踪提供者对结果可以为质量改进策略提供信息，例如优化团队人员配置，确定高绩效团队的特征和实践，制定循证团队指南，以及重新设计住院护理流程。
The nature of teamwork in healthcare is complex and interdisciplinary, and provider collaboration based on shared patient encounters is crucial to its success. Characterizing the intensity of working relationships with risk adjusted patient outcomes supplies insight into provider interactions in a hospital environment. We extracted four years of patient, provider, and activity data for encounters in an inpatient cardiology unit from Northwestern Medicine’s Enterprise Data Warehouse. We then created a provider-patient network to identify healthcare providers who jointly participated in patient encounters and calculated satisfaction rates for provider-provider pairs. We demonstrated the application of a novel parameter, the Shared Positive Outcome Ratio (SPOR), an objective composite measure that quantifies a given pair’s concentration of positive outcomes over a set of shared patients. We compared an observed collaboration network of 334 providers and 3,453 relationships to 1,000 networks with SPOR scores based on randomized outcomes and found 188 collaborative relationships between pairs of providers that showed significantly higher than expected patient satisfaction ratings. A group of 22 providers performed exceptionally in terms of patient satisfaction. Our results indicate high variability in collaboration scores across the network and highlight our ability to identify relationships with both higher and lower than expected scores across a set of shared patient encounters. Satisfaction rates appear to vary across different teams of providers. Team collaboration can be quantified using a composite measure of collaboration across provider pairs. Tracking provider pair outcomes over a sufficient set of shared encounters may inform quality improvement strategies, such as optimizing team staffing, identifying characteristics and practices of high-performing teams, developing evidence-based team guidelines, and redesigning inpatient care processes.