Findings from an Organizational Network Analysis to Support Local Public Health Management

Merrill, Jacqueline; Caldwell, Michael S.; Rockoff, Maxine L.; Gebbie, Kristine M.; Carley, Kathleen M.; Bakken, Suzanne

doi:10.1007/s11524-008-9277-8

Cited by 35 publications

(28 citation statements)

References 35 publications

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“…Although the Benham-Hutchins study focused on the communication among multiple professions during the handoff, this study involved only nursing personnel. Finally, none of the prior healthcare studies using *ORA 16, 29–30 associated handoff network characteristics with patient outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Using *ORA, a Network Analysis Tool, to Assess the Relationship of Handoffs to Quality and Safety Outcomes

Effken

Gephart

Brewer

et al. 2013

CIN: Computers, Informatics, Nursing

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Communication during patient handoffs has been widely implicated in patient safety issues. However, few studies have actually been able to quantify the relationship between handoffs and patient outcomes. We used *ORA, a dynamic network analysis tool, to examine handoffs between day and night shifts on seven units in three hospitals in the Southwest. Using *ORA’s visualization and analysis capabilities we examined the relationships between the handoff communication network metrics and a variety of patient safety quality and satisfaction outcomes. Unique network patterns were observed for different types of outcome variable (e.g., safety, symptom management, self care, and patient satisfaction). This exploratory project demonstrates the power of *ORA to identify communication patterns for large groups, such as patient care units. *ORA’s network metrics can then be related to specific patient outcomes.

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Section: Discussionmentioning

confidence: 99%

“…25–28 In healthcare, *ORA has been less widely used. However, Merrill and colleagues used *ORA to examine the impact of an impending merger of public health programs; 29–30 and Benham-Hutchins and Effken used *ORA to examine handoffs from the Emergency Department Staff to other medical-surgical unit staff in one hospital. 16 …”

Section: Introductionmentioning

confidence: 99%

Using *ORA, a Network Analysis Tool, to Assess the Relationship of Handoffs to Quality and Safety Outcomes

Effken

Gephart

Brewer

et al. 2013

CIN: Computers, Informatics, Nursing

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“…These categories were developed to address the collaborative culture of public health, a suspected source of overresponse bias (overestimating communication links) identified in our pilot work. 18,19 The responses to section I of the survey produced the employee-to-employee network. Responses that indicated both frequent and not frequent communication produced a network representing “all ties” between employees.…”

Section: Methodsmentioning

confidence: 99%

“…The nonlinear pattern of links between divisions in the network presents a striking contrast to the directed hierarchy of the organizational chart. From Merrill et al 19 …”

Section: Figurementioning

confidence: 99%

A Comparative Study of 11 Local Health Department Organizational Networks

Merrill

Keeling

Carley

2010

Journal of Public Health Management and Practice

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Context Although the nation’s local health departments (LHDs) share a common mission, variability in administrative structures is a barrier to identifying common, optimal management strategies. There is a gap in understanding what unifying features LHDs share as organizations that could be leveraged systematically for achieving high performance. Objective To explore sources of commonality and variability in a range of LHDs by comparing intraorganizational networks. Intervention We used organizational network analysis to document relationships between employees, tasks, knowledge, and resources within LHDs, which may exist regardless of formal administrative structure. Setting A national sample of 11 LHDs from seven states that differed in size, geographic location, and governance. Participants Relational network data were collected via an on-line survey of all employees in 11 LHDs. A total of 1 062 out of 1 239 employees responded (84% response rate). Outcome Measures Network measurements were compared using coefficient of variation. Measurements were correlated with scores from the National Public Health Performance Assessment and with LHD demographics. Rankings of tasks, knowledge, and resources were correlated across pairs of LHDs. Results We found that 11 LHDs exhibited compound organizational structures in which centralized hierarchies were coupled with distributed networks at the point of service. Local health departments were distinguished from random networks by a pattern of high centralization and clustering. Network measurements were positively associated with performance for 3 of 10 essential services (r > 0.65). Patterns in the measurements suggest how LHDs adapt to the population served. Conclusions Shared network patterns across LHDs suggest where common organizational management strategies are feasible. This evidence supports national efforts to promote uniform standards for service delivery to diverse populations.

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“…Previous studies have applied network analysis to communication patterns of workers within local health departments and interrelationships within public health agencies, 5,6 cooccurrence of words and citation patterns in the US Code, 7 and citation patterns in French legal codes. 8 The network analysis tool might equally well provide a way to analyze the qualities of emergency PHS networks.…”

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confidence: 99%