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Using Epistemic Network Analysis to Explore Outcomes of Care Transitions

  • Abigail R. WooldridgeEmail author
  • RuthAnn Haefli
Conference paper
Part of the Communications in Computer and Information Science book series (CCIS, volume 1112)

Abstract

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.

Keywords

Care transition outcomes Handoffs Epistemic network analysis 

Notes

Acknowledgements

Funding for this research was provided by the Agency for Healthcare Research and Quality (AHRQ) [Grant No. R01-HS023837] (PI: Ayse P. Gurses, Johns Hopkins University; PI of UW-Madison subcontract: Pascale Carayon) and the Research Experience for Undergraduates program of the Department of Industrial and Enterprise Systems Engineering at the University of Illinois at Urbana-Champaign. This work was funded in part by the National Science Foundation (DRL-1661036, DRL-1713110), the Wisconsin Alumni Research Foundation, and the Office of the Vice Chancellor for Research and Graduate Education at the University of Wisconsin-Madison. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. We thank the study participants, as our research would not be possible without them.

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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.University of Illinois at Urbana-ChampaignUrbanaUSA

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