Characterizing Teamwork in Cardiovascular Care Outcomes

A Network Analytics Approach

Matthew B. Carson*, Denise M Scholtens, Conor N. Frailey, Stephanie J. Gravenor, Emilie Susan Powell, Amy Y Wang, Gayle Shier Kricke, Faraz Ahmad, R Kannan Mutharasan, Nicholas Dean Soulakis

*Corresponding author for this work

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background - 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. Methods and Results - We extracted 4 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, a measure that assesses the strength of a patient-sharing relationship between 2 providers based on risk-adjusted encounter outcomes. We compared an observed collaboration network of 334 providers and 3453 relationships to 1000 networks with shared positive outcome ratio 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. Conclusions - Satisfaction rates seem 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.

Original languageEnglish (US)
Pages (from-to)670-678
Number of pages9
JournalCirculation: Cardiovascular Quality and Outcomes
Volume9
Issue number6
DOIs
StatePublished - Nov 1 2016

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Patient Satisfaction
Inpatients
Aptitude
Quality Improvement
Cardiology
Health Personnel
Medicine
Guidelines
Delivery of Health Care

Keywords

  • cardiology
  • data mining
  • inpatients
  • patient satisfaction
  • quality improvement
  • statistical model

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Characterizing Teamwork in Cardiovascular Care Outcomes: A Network Analytics Approach",
abstract = "Background - 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. Methods and Results - We extracted 4 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, a measure that assesses the strength of a patient-sharing relationship between 2 providers based on risk-adjusted encounter outcomes. We compared an observed collaboration network of 334 providers and 3453 relationships to 1000 networks with shared positive outcome ratio 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. Conclusions - Satisfaction rates seem 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.",
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Characterizing Teamwork in Cardiovascular Care Outcomes : A Network Analytics Approach. / Carson, Matthew B.; Scholtens, Denise M; Frailey, Conor N.; Gravenor, Stephanie J.; Powell, Emilie Susan; Wang, Amy Y; Kricke, Gayle Shier; Ahmad, Faraz; Mutharasan, R Kannan; Soulakis, Nicholas Dean.

In: Circulation: Cardiovascular Quality and Outcomes, Vol. 9, No. 6, 01.11.2016, p. 670-678.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Characterizing Teamwork in Cardiovascular Care Outcomes

T2 - A Network Analytics Approach

AU - Carson, Matthew B.

AU - Scholtens, Denise M

AU - Frailey, Conor N.

AU - Gravenor, Stephanie J.

AU - Powell, Emilie Susan

AU - Wang, Amy Y

AU - Kricke, Gayle Shier

AU - Ahmad, Faraz

AU - Mutharasan, R Kannan

AU - Soulakis, Nicholas Dean

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background - 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. Methods and Results - We extracted 4 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, a measure that assesses the strength of a patient-sharing relationship between 2 providers based on risk-adjusted encounter outcomes. We compared an observed collaboration network of 334 providers and 3453 relationships to 1000 networks with shared positive outcome ratio 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. Conclusions - Satisfaction rates seem 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.

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KW - data mining

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KW - quality improvement

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