title: An Outcome-Weighted Network Model for Characterizing Collaboration.
abstract: Shared patient encounters form the basis of collaborative relationships, which are crucial to the success of complex and interdisciplinary teamwork in healthcare. Quantifying the strength of these relationships using shared risk-adjusted patient outcomes provides insight into interactions that occur between healthcare providers. We developed the Shared Positive Outcome Ratio (SPOR), a novel parameter that quantifies the concentration of positive outcomes between a pair of healthcare providers over a set of shared patient encounters. We constructed a collaboration network using hospital emergency department patient data from electronic health records (EHRs) over a three-year period. Based on an outcome indicating patient satisfaction, we used this network to assess pairwise collaboration and evaluate the SPOR. By comparing this network of 574 providers and 5,615 relationships to a set of networks based on randomized outcomes, we identified 295 (5.2%) pairwise collaborations having significantly higher patient satisfaction rates. Our results show extreme high- and low-scoring relationships over a set of shared patient encounters and quantify high variability in collaboration between providers. We identified 29 top performers in terms of patient satisfaction. Providers in the high-scoring group had both a greater average number of associated encounters and a higher percentage of total encounters with positive outcomes than those in the low-scoring group, implying that more experienced individuals may be able to collaborate more successfully. Our study shows that a healthcare collaboration network can be structurally evaluated to characterize the collaborative interactions that occur between healthcare providers in a hospital setting.
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Matthew B
authors.identifier: http://orcid.org/0000-0003-4105-9220
authors.initials: MB
authors.lastname: Carson
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Denise M
authors.initials: DM
authors.lastname: Scholtens
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Conor N
authors.initials: CN
authors.lastname: Frailey
authors.affiliation: Department of Emergency Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Gravenor
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Gayle E
authors.initials: GE
authors.lastname: Kricke
authors.affiliation: Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.
authors.forename: Nicholas D
authors.initials: ND
authors.lastname: Soulakis
mesh_terms: D000066491:Clinical Decision-Making; D003299:Cooperative Behavior; D057286:Electronic Health Records; D004636:Emergency Service, Hospital; D006282:Health Personnel; D006801:Humans; D008962:Models, Theoretical; D010348:Patient Care Team / Q000458:organization & administration*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D014584:User-Computer Interface