Characterizing intensive care unit rounding teams using meta-data from the electronic health record

Area of Science:

• Critical care medicine
• Health informatics
• Organizational behavior

Background:

• Teamwork is crucial for patient outcomes in intensive care units (ICUs).
• Understanding the composition and dynamics of individual ICU teams is essential but challenging.
• Existing methods for characterizing ICU teams are limited.

Purpose of the Study:

• To investigate the utility of electronic health record (EHR) metadata for identifying and characterizing intensive care unit (ICU) teams.
• To explore how digital signatures within EHRs can define team structures and member interactions.
• To assess the potential of EHR metadata in understanding team dynamics in critical care settings.

Main Methods:

• Analysis of EHR data from 27 ICUs over a one-year period.
• Linking physicians, nurses, and respiratory therapists to patients using EHR metadata.
• Characterizing ICU teams by member experience and shared experience, employing network analysis for density and centralization.

Main Results:

• Identification of 2327 unique providers and 30,892 unique care teams.
• Significant variation observed in average team member experience and shared experience across teams.
• Substantial variability in ICU network density, degree centralization, and closeness centralization.

Conclusions:

• EHR metadata provides a viable method for characterizing ICU teams.
• This approach offers novel insights into team function and performance metrics in critical care.
• Findings suggest potential for developing data-driven strategies to enhance ICU team effectiveness.