Collaboration Structures in COVID-19 Critical Care: Retrospective Network Analysis Study.

Area of Science:

• Critical Care Medicine
• Health Services Research
• Network Science

Background:

• Intensive care unit (ICU) staffing studies rarely examine health care worker (HCW) collaboration structures.
• Understanding HCW connections in COVID-19 critical care is crucial for team structures, care quality, and patient safety.

Purpose of the Study:

• To compare teamwork structures in COVID-19 and non-COVID-19 critical care.
• To identify differences in HCW collaboration patterns during the COVID-19 pandemic.

Main Methods:

• Retrospective analysis of electronic health records (EHRs) for 76 critically ill patients (38 COVID-19, 38 non-COVID-19).
• Utilized network analysis with eigencentrality and betweenness to quantify HCW collaboration and status.
• Assessed patient staffing intensity by the number of interacting HCWs.

Main Results:

• HCWs in COVID-19 ICUs showed higher collaboration (eigencentrality) than in non-COVID-19 ICUs.
• Internal medicine physicians had higher core status in COVID-19 care; nurse practitioners had higher betweenness status.
• COVID-19 patients' EHRs involved more internal medicine NPs, cardiovascular nurses, and surgical ICU nurses, but fewer resident physicians.

Conclusions:

• Network analysis of EHR data offers a novel method to study collaboration structure differences between COVID-19 and non-COVID-19 critical care.
• Findings highlight pandemic-induced changes in urgent care collaboration structures for healthcare organizations.