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Nursing Unit Communication During a US Public Health Emergency: Natural Experiment.

Marge Benham-Hutchins1,2, Kathleen M Carley3, Barbara B Brewer4

  • 1School of Nursing University of Texas at Austin Austin, TX United States.

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Summary

The Ebola virus disease (EVD) outbreak created a natural experiment, revealing changes in hospital communication networks and patient safety outcomes. Social network analysis (SNA) metrics shifted during the crisis, impacting care quality.

Keywords:
Ebola virus diseasenatural experimentnursingnursing unit communicationpublic health emergencysocial network analysis

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Area of Science:

  • Healthcare Management
  • Epidemiology
  • Social Network Analysis

Background:

  • The 2014 Ebola virus disease (EVD) outbreak in the US presented a unique public health crisis.
  • This study leveraged the EVD emergency as a natural experiment during a longitudinal study on nursing communication and patient outcomes.
  • Data collection for the Measuring Network Stability and Fit (NetFIT) study occurred near an initial EVD diagnosis site.

Purpose of the Study:

  • To analyze nursing unit communication and information-sharing network structures.
  • To identify stable network metrics for longitudinal analysis.
  • To explore the relationship between unit context, network metrics, and patient safety outcomes.
  • To report on communication and outcome changes during the EVD crisis.

Main Methods:

  • Focused on 10 hospital units with data collected before, during, and after the EVD crisis.
  • Aggregated individual nursing staff network data to the unit level.
  • Collected data on communication network metrics and three patient safety outcomes: fall rate, medication errors, and pressure ulcers.

Main Results:

  • Analysis included 40 data points from 608 healthcare staff.
  • Observed changes in social network analysis (SNA) metrics (e.g., average distance, diffusion, density) correlated with patient safety outcome changes.
  • Units in the hospital near the EVD case showed significant shifts in patient outcomes and network communication.

Conclusions:

  • Public health emergencies like EVD can significantly alter hospital communication networks and patient outcomes.
  • Social network analysis (SNA) is a valuable tool for studying the impact of crises on healthcare systems.
  • Further research is recommended to explore these relationships in future public health emergencies.