Characterizing nursing home care team communication via text messaging: A social network analysis

Area of Science:

• Healthcare Communication
• Social Network Analysis
• Nursing Home Operations

Background:

• Communication breakdowns in healthcare teams lead to adverse events.
• Text messaging is increasingly used for care coordination in nursing homes.
• Understanding how these platforms integrate into communication networks is crucial.

Purpose of the Study:

• To characterize text-message communication patterns among nursing home care teams.
• To examine how network structures reflect social system dynamics.
• To identify distinct communication models within nursing home settings.

Main Methods:

• Social network analysis of 5,092 text messages related to 585 nursing home-to-hospital transfers (2015-2020).
• Calculation of network measures including density, centralization, and reciprocity.
• Qualitative classification of networks into communication models using Diffusion of Innovations theory.

Main Results:

• Three communication models were identified: Integrated (high connectivity, low hierarchy), Hub-and-Spoke (centralized, hierarchical), and Siloed (niche use).
• Integrated model reflects mature adoption of text messaging for collaboration.
• Hub-and-Spoke model indicates protocol-driven communication; Siloed model shows role-specific use.
• Central individuals acted as informal opinion leaders, influencing communication through interaction.

Conclusions:

• Communication network structure influences information flow, influence, and innovation integration in nursing homes.
• Social network analysis provides a method for evaluating implementation and guiding communication strategies.
• Further research should explore the link between integrated communication networks and improved resident outcomes.