title: Understanding the use and impact of the online community in a national quality improvement campaign.
abstract: BACKGROUND
  National quality campaigns often sponsor online communities; however, little is known about whether and how organisations use these communities, and the impact of their use.
  
  
  METHODS
  We conducted a longitudinal study of the D2B Online Community, which was sponsored by the D2B Alliance, a campaign to improve heart attack care. We examined community use, helpfulness, and impact on care for 731 Alliance-hospitals. Our data sources were a hospital survey, the archive of messages sent and the National Cardiovascular Data Registry's time-to-treatment data.
  
  
  RESULTS
  About 52% of hospitals (n=378/731) studied used the online community, with 27% of hospitals (n=195) contributing messages to the online community, while 25% (n=183) were silent users. Silent users were hospitals that reported staff use of the online community, but their staff did not send any messages. In the vast majority of contributing hospitals, only one individual contributed messages to the community. Contributing individuals, mostly nurses (70%), sent a total of 1155 messages, with 36% of messages sent by 11 high-volume users (5%). Messages discussed techniques for improving performance, performance measurement issues, location and interpretation of expert guidance and how to manage staff role changes. We found no statistical association between community use and improved time-to-treatment; however, many users rated the community highly for helpfulness.
  
  
  CONCLUSIONS
  Many organisations used the online community for information exchange and found it helpful, despite its lack of association with performance improvement, suggesting what benefits there are may not directly link to performance.
authors.affiliation: Yale University, School of Public Health/School of Medicine, New Haven, Connecticut 06520-8034, USA. ingrid.nembhard@yale.edu
authors.forename: Ingrid M
authors.initials: IM
authors.lastname: Nembhard
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Nazem
authors.forename: Tashonna R
authors.initials: TR
authors.lastname: Webster
authors.forename: Yongfei
authors.initials: Y
authors.lastname: Wang
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Bradley
mesh_terms: D006265:Health Care Coalitions / Q000706:statistics & numerical data*; D006764:Hospitals, Community; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009862:Online Systems; D058996:Quality Improvement; D012042:Registries; D014481:United States