Abstract
BackgroundEmergency departments (EDs) are high pressure health care settings involving complex interactions between staff members in providing and organising patient care. Without good communication and cooperation amongst members of the ED team, quality of care is at risk. This study examined the problem-solving, medication advice-seeking and socialising networks of staff working in an Australian hospital ED.MethodsA social network survey (Response Rate = 94%) was administered to all ED staff (n = 109) including doctors, nurses, allied health professionals, administrative staff and ward assistants. Analysis of the network characteristics was carried out by applying measures of density (the extent participants are concentrated), connectedness (how related they are), isolates (how segregated), degree centrality (who has most connections measured in two ways, in-degree, the number of ties directed to an individual and out-degree, the number of ties directed from an individual), betweenness centrality (who is important or powerful), degree of separation (how many ties lie between people) and reciprocity (how bi-directional are interactions).ResultsIn all three networks, individuals were more closely connected to colleagues from within their respective professional groups. The problem-solving network was the most densely connected network, followed by the medication advice network, and the loosely connected socialising network. ED staff relied on each other for help to solve work-related problems, but some senior doctors, some junior doctors and a senior nurse were important sources of medication advice for their ED colleagues.ConclusionsNetwork analyses provide useful ways to assess social structures in clinical settings by allowing us to understand how ED staff relate within their social and professional structures. This can provide insights of potential benefit to ED staff, their leaders, policymakers and researchers.
Highlights
Emergency departments (EDs) are high pressure health care settings involving complex interactions between staff members in providing and organising patient care
Emergency departments (EDs) are complex health care settings, characterised as high pressure, high intensity environments in which it can be stressful to work[1,2]
Analysis of the network characteristics was carried out by applying measures of connectedness, isolates, degree centrality, betweenness centrality, degree of separation and reciprocity for the three networks
Summary
Emergency departments (EDs) are high pressure health care settings involving complex interactions between staff members in providing and organising patient care. Without good communication and cooperation amongst members of the ED team, quality of care is at risk. Emergency departments (EDs) are complex health care settings, characterised as high pressure, high intensity environments in which it can be stressful to work[1,2]. Staff carry out organisational work and clinical work simultaneously in order to manage and deliver patient care[8] and they relate to most other departments within the hospital to accomplish treatment and placement of patients if they are to be admitted or returned to the community[9,10,11]. Without good communication and cooperation amongst members of an ED team, people will lack vital information. Poor communication and coordination have been identified as research priorities for improving patient safety in developed countries[13]
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