Examining Diurnal Differences in Multidisciplinary Care Teams at a Pediatric Trauma Center Using Electronic Health...

Area of Science:

• Medical Informatics
• Network Science
• Pediatric Trauma Care

Background:

• Pediatric trauma patient care involves dynamic, multidisciplinary teams.
• Team composition and organization can vary significantly based on the time of day.

Purpose of the Study:

• To identify and describe diurnal variations in multidisciplinary care teams for pediatric trauma patients.
• Utilize social network analysis on electronic health record (EHR) data to map team dynamics.

Main Methods:

• Extracted clinical activity metadata from EHRs, creating event logs stratified by shift (day/night) and location (ED, PICU, floor).
• Constructed social networks from event logs, identifying overlapping communities to represent team structures.
• Validated findings through qualitative data from semistructured and member-checking interviews.

Main Results:

• Analyzed 413 patient encounters over 1 year; 65.9% started during the day, 34.1% at night.
• Identified a single community during daytime shifts and in the PICU at night.
• Observed multiple, fragmented communities in the ED and on the floor at night, with trauma service members coordinating care.

Conclusions:

• Social network analysis effectively visualized diurnal shifts in pediatric trauma care team composition and organization.
• EHR data can reveal dynamic changes in multidisciplinary team structures, aiding in understanding care coordination challenges.