title: Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.
abstract: BACKGROUND
  The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention.
  
  
  OBJECTIVE
  In this research, we describe a mixed method approach to explore communication strategies used by healthcare providers for resident skin risk in NH with high IT sophistication (ITS).
  
  
  METHODS
  Sample included NH participating in the statewide survey of ITS. We incorporated rigorous observation of 8- and 12-h shifts, and focus groups to identify how NH IT and a range of synchronous and asynchronous tools are used. Social network analysis tools and qualitative analysis were used to analyze data and identify relationships between ITS dimensions and communication interactions between care providers.
  
  
  RESULTS
  Two of the nine ITS dimensions (resident care-technological and administrative activities-technological) and total ITS were significantly negatively correlated with number of unique interactions. As more processes in resident care and administrative activities are supported by technology, the lower the number of observed unique interactions. Additionally, four thematic areas emerged from staff focus groups that demonstrate how important IT is to resident care in these facilities including providing resident-centered care, teamwork and collaboration, maintaining safety and quality, and using standardized information resources.
  
  
  CONCLUSIONS
  Our findings in this study confirm prior research that as technology support (resident care and administrative activities) and overall ITS increases, observed interactions between staff members decrease. Conversations during staff interviews focused on how technology facilitated resident centered care through enhanced information sharing, greater virtual collaboration between team members, and improved care delivery. These results provide evidence for improving the design and implementation of IT in long term care systems to support communication and associated resident outcomes.
authors.affiliation: University of Missouri, Sinclair School of Nursing, United States. Electronic address: alexanderg@missouri.edu.
authors.forename: Gregory L
authors.initials: GL
authors.lastname: Alexander
authors.affiliation: Health Care Policy & Research, Mayo Clinic, 200 First Street SW, Harwick Bldg. 2-42, Rochester, MN 55905, United States. Electronic address: Pasupathy.Kalyan@mayo.edu.
authors.forename: Kalyan S
authors.initials: KS
authors.lastname: Pasupathy
authors.affiliation: School of Nursing, University of Wisconsin - Madison, 600 Highland Avenue, K6/362 CSC, Madison, WI 53792-2455, United States. Electronic address: LSteege@wisc.edu.
authors.forename: Linsey M
authors.initials: LM
authors.lastname: Steege
authors.affiliation: University of Missouri, Sinclair School of Nursing, United States. Electronic address: ebs4k8@mail.missouri.edu.
authors.forename: E Bradley
authors.initials: EB
authors.lastname: Strecker
authors.affiliation: Institute for Software Research, Carnegie Mellon University, Office: Wean Hall 5130, Pittsburgh, PA 15213, United States. Electronic address: kathleen.carley@cs.cmu.edu.
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Carley
mesh_terms: D003195:Computer Communication Networks / Q000458:organization & administration*; D017144:Focus Groups; D006801:Humans; D007256:Information Systems / Q000706:statistics & numerical data*; D033183:Interdisciplinary Communication; D009735:Nursing Homes / Q000458:organization & administration*; D058996:Quality Improvement; D018570:Risk Assessment / Q000379:methods*; D017592:Skin Care
keywords: Communication; Information technology; Nursing home; Social network analysis; Workflow