TY - GEN
T1 - Using Epistemic Network Analysis to Explore Outcomes of Care Transitions
AU - Wooldridge, Abigail R.
AU - Haefli, Ruth Ann
PY - 2019/1/1
Y1 - 2019/1/1
N2 - Care transitions are important to patient safety, but we lack consensus on what outcomes of transitions to evaluate. We interviewed 28 physicians and nurses who participate in transitions of adult and pediatric trauma patients from the operating room to the intensive care unit. The handoff (i.e., communication about patient information) in the pediatric care transition was done together as a team while the other handoff was separated by profession. In this study, we identify nine care transition outcomes: (1) communication sufficiency, completeness and accuracy, (2) handoff timing, (3) patient outcomes, (4) change in workload, (5) individual situation awareness, (6) team situation awareness, (7) organization awareness, (8) team experience and (9) timing of feedback. These outcomes could be positive and negative (i.e., good or bad). This study also investigates relationships between outcomes in the two groups using epistemic network analysis (ENA). While we found the no difference between the outcomes in the team and separate handoff when comparing frequency counts, relationships between outcomes did differ when using ENA. Interviewees with the team handoff described more relationships between care team level outcomes – team situation awareness and team experience – and other outcomes, while interviewees with the separate handoffs focused on the relationship between communication and patient outcome. Future work should investigate differences in relationships between positive and negative valences of the outcomes.
AB - Care transitions are important to patient safety, but we lack consensus on what outcomes of transitions to evaluate. We interviewed 28 physicians and nurses who participate in transitions of adult and pediatric trauma patients from the operating room to the intensive care unit. The handoff (i.e., communication about patient information) in the pediatric care transition was done together as a team while the other handoff was separated by profession. In this study, we identify nine care transition outcomes: (1) communication sufficiency, completeness and accuracy, (2) handoff timing, (3) patient outcomes, (4) change in workload, (5) individual situation awareness, (6) team situation awareness, (7) organization awareness, (8) team experience and (9) timing of feedback. These outcomes could be positive and negative (i.e., good or bad). This study also investigates relationships between outcomes in the two groups using epistemic network analysis (ENA). While we found the no difference between the outcomes in the team and separate handoff when comparing frequency counts, relationships between outcomes did differ when using ENA. Interviewees with the team handoff described more relationships between care team level outcomes – team situation awareness and team experience – and other outcomes, while interviewees with the separate handoffs focused on the relationship between communication and patient outcome. Future work should investigate differences in relationships between positive and negative valences of the outcomes.
KW - Care transition outcomes
KW - Epistemic network analysis
KW - Handoffs
UR - http://www.scopus.com/inward/record.url?scp=85075746882&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85075746882&partnerID=8YFLogxK
U2 - 10.1007/978-3-030-33232-7_21
DO - 10.1007/978-3-030-33232-7_21
M3 - Conference contribution
AN - SCOPUS:85075746882
SN - 9783030332310
T3 - Communications in Computer and Information Science
SP - 245
EP - 256
BT - Advances in Quantitative Ethnography - 1st International Conference, ICQE 2019, Proceedings
A2 - Eagan, Brendan
A2 - Siebert-Evenstone, Amanda
A2 - Misfeldt, Morten
PB - Springer
T2 - 1st International Conference on Quantitative Ethnography, ICQE 2019
Y2 - 20 October 2019 through 22 October 2019
ER -