Collaborative Care Network Research Articles

Communication Commentary: Bipolar Disorder: The Roller Coaster Ride: Optimizing the Therapeutic Alliance with Patients with Bipolar Disorder

Communication Commentary: Bipolar Disorder: The Roller Coaster Ride: Optimizing the Therapeutic Alliance with Patients with Bipolar Disorder

Coolfarming Lessons from the Beehive to Increase Organizational Creativity

This paper introduces Collaborative Innovation Networks as an engine for self-organizing disruptive innovation. It is illustrated by the metaphor of the bee swarm through four lessons from the beehive: “centralized leadership – rotating leaders – waggle dance – attraction pheromone” as key principles for managing self-organizing teams of creators. In combination with applying social network analysis through knowledge flow optimization, managers get a powerful new tool to radically increase creativity and performance of their organizations. Among many well-known examples (LEGO Mindstorms, Apple, Wikipedia), the paper also introduces an extensive case study in health are, the C3N project which creates Collaborative Care Networks for patients of chronic diseases.

Collaborative Care Well Suited to New Medicaid Health Home Option

Collaborative Care Well Suited to New Medicaid Health Home Option

Collaborative Chronic Care Networks (C3Ns) to Transform Chronic Illness Care

Despite significant gains by pediatric collaborative improvement networks, the overall US system of chronic illness care does not work well. A new paradigm is needed: a Collaborative Chronic Care Network (C3N). A C3N is a network-based production system that harnesses the collective intelligence of patients, clinicians, and researchers and distributes the production of knowledge, information, and know-how over large groups of people, dramatically accelerating the discovery process. A C3N is a platform of "operating systems" on which interconnected processes and interventions are designed, tested, and implemented. The social operating system is facilitated by community building, engaging all stakeholders and their expertise, and providing multiple ways to participate. Standard progress measures and a robust information technology infrastructure enable the technical operating system to reduce unwanted variation and adopt advances more rapidly. A structured approach to innovation design provides a scientific operating system or "laboratory" for what works and how to make it work. Data support testing and research on multiple levels: comparative effectiveness research for populations, evaluating care delivery processes at the care center level, and N-of-1 trials and other methods to select the best treatment of individual patient circumstances. Methods to reduce transactional costs to participate include a Federated IRB Model in which centers rely on a protocol approved at 1 central institutional review board and a "commons framework" for organizational copyright and intellectual property concerns. A fully realized C3N represents a discontinuous leap to a self-developing learning health system capable of producing a qualitatively different approach to improving health.

Prevention of central line associated bloodstream infections in critical care units

Central line associated bloodstream infections (CLABSIs) are a common source of morbidity and mortality in neonatal and pediatric intensive care units. Successful preventive strategies have recently been reported which have resulted in significant reductions in CLABSIs and their associated adverse outcomes. Current surveillance data indicate a recent decline in reported CLABSI rates, likely secondary to changes in diagnostic criteria and improvements in central line care. Recent pilot randomized trials in the neonatal intensive care unit population have assessed the safety and efficacy of chlorhexidine gluconate for cutaneous antisepsis and silver alginate-impregnated dressings. No significant reductions in CLABSIs have been noted with the use of either. The greatest success has come with implementation of evidence-based catheter care bundles, which have been shown in individual units and collaborative critical care networks to significantly reduce CLABSI rates. CLABSIs remain a significant problem in neonatal and pediatric critical care units, but implementation of catheter care bundles can significantly reduce rates of these infections. The safety and efficacy of chlorhexidine gluconate, silver alginate, and antibiotic-coated catheters need to be assessed via large, multicenter trials. Creation of collaborative networks may facilitate this goal.

Building legitimacy and the early growth of health networks for the uninsured.

An integrated system of health care for serving the uninsured population of one community was followed from formation through early growth. Funding was provided through the Health Resources Services Administration's Community Access Program to bring together a diverse set of health care providers to form a collaborative network managed by a central administrative entity. Legitimacy building was critical for explaining how the network evolved and the effectiveness of the network in sustaining itself and building a patient base. Based on the study's results, conclusions are drawn that contribute to theory on network legitimacy in health care. In addition, lessons learned are offered that may help other communities address the health needs of the uninsured through collaborative health care networks.