Exploring the use of social network methods in designing healthcare quality improvement teams

Abstract

Teams are an integral component of quality improvement efforts in healthcare organizations. Quality improvement teams may involve persons either from the same or different disciplines. In either case, the selection of team members may be critical to the team's success. However, there is little research to guide selection of team members for quality improvement teams. In this paper, we use tools from social network analysis (SNA) to derive principles for the design of effective clinical quality improvement teams and explore the implementation of these principles using social network data collected from the inpatient general medicine services at a large academic medical center in Chicago, USA. While the concept of multidisciplinary teams focuses on the importance of the professional background of team members, SNA emphasizes the importance of the individual and collective connections of team members, both to persons outside the team and to each other. SNA also focuses on the location of individuals and groups between other actors in the flow of information and other resources within larger organizational networks. We hypothesize that external connections may be most important when the collection or dissemination of information or influence are the greatest concerns, while the relationship of team members to each other may matter most when internal coordination, knowledge sharing, and within-group communication are most important. Our data suggest that the social networks of the attending physicians can be characterized sociometrically and that new sociometric measures such as "net degree" may be useful in identifying teams with the greatest potential for external influence.

FIGURE 1

SNA Implications of Diversifying Team Composition

FIGURE 2

SNA Concepts of Degree, Betweenness, and Bridges

Figure 3

University of Chicago Attending Social Network Survey Sociometric Matrix

FIGURE 4

Sociogram of 2006–2007 General Medicine Inpatient Attending Physician Social Network

FIGURE 5

Professional and Sociodemographic Network Partitions

FIGURE 5

Professional and Sociodemographic Network Partitions

FIGURE 5

Professional and Sociodemographic Network Partitions

FIGURE 6

FIGURE 7

Distribution of Net Degree in Two-Person Teams

FIGURE 8

Network Partition by Betweenness