Social Network Analysis of Secure Text Messaging Metadata During Clinical Deterioration in an Inpatient Children's...

Area of Science:

• Healthcare communication
• Medical informatics
• Network science

Background:

• Effective healthcare team communication is crucial for timely recognition and intervention in clinical deterioration.
• Secure text messaging is increasingly utilized for healthcare provider (HP) communication in inpatient settings.

Purpose of the Study:

• To quantitatively characterize HP communication networks using social network analysis (SNA) of secure text messages.
• To investigate communication patterns related to patient deterioration within these networks.

Main Methods:

• Analyzed over 1 million secure text messages exchanged between 3,272 HPs over 12 months.
• Constructed subnetworks for individual patient encounters, focusing on those with clinical deterioration.
• Calculated network characteristics, including eigenvector centrality, to assess provider influence.

Main Results:

• Frontline providers (FLPs), including advanced practice providers and housestaff, showed significantly higher eigenvector centrality, indicating greater influence on information dissemination.
• FLPs demonstrated increased network influence within subnetworks caring for deteriorating patients compared to those not experiencing deterioration.
• This heightened influence was observed despite similar network sizes and participant numbers.

Conclusions:

• SNA quantitatively characterizes inpatient HP communication networks, highlighting the central role of FLPs in information flow.
• Understanding these communication dynamics, particularly for deteriorating patients, offers targets for improving communication and mitigating clinical risks.