Network approaches and interventions in healthcare settings: A systematic scoping review

Abstract

Introduction The growing interest in networks of interactions is sustained by the conviction that they can be leveraged to improve the quality and efficiency of healthcare delivery systems. Evidence in support of this conviction, however, is mostly based on descriptive studies. Systematic evaluation of the outcomes of network interventions in healthcare settings is still wanting. Despite the proliferation of studies based on Social Network Analysis (SNA) tools and techniques, we still know little about how intervention programs aimed at altering existing patterns of social interaction among healthcare providers affect the quality of service delivery. We update and extend prior reviews by providing a comprehensive assessment of available evidence. Methods and findings We searched eight databases to identify papers using SNA in healthcare settings published between 1st January 2010 and 1st May 2022. We followed Chambers et al.’s (2012) approach, using a Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. We distinguished between studies relying on SNA as part of an intervention program, and studies using SNA for descriptive purposes only. We further distinguished studies recommending a possible SNA-based intervention. We restricted our focus on SNA performed on networks among healthcare professionals (e.g., doctors, nurses, etc.) in any healthcare setting (e.g., hospitals, primary care, etc.). Our final review included 102 papers. The majority of the papers used SNA for descriptive purposes only. Only four studies adopted SNA as an intervention tool, and measured outcome variables. Conclusions We found little evidence for SNA-based intervention programs in healthcare settings. We discuss the reasons and challenges, and identify the main component elements of a network intervention plan. Future research should seek to evaluate the long-term role of SNA in changing practices, policies and behaviors, and provide evidence of how these changes affect patients and the quality of service delivery.

Describing nurses' communication about evidence‐based practice change: A social network analysis of hospital nurses

“…This foundational knowledge can inform future work to understand the communication structure and its impact on the adoption of EBPs. Exploring these structures using SNA allows for the dynamics of the whole nursing unit to be examined, rather than only individual behaviors, which likely has more influence on the uptake of EBPs (Saatchi et al., 2023). This approach expands our knowledge of how to apply implementation strategies to improve EBP uptake and responds to the call for increased network analysis to generate nursing knowledge for a variety of topics, including EBP (Lee, 2019).…”

“…Interest in SNA in health care has increased since the early 2000s (Glegg et al., 2019); however, its use in nursing studies has been limited (Kantek et al., 2022; Saatchi et al., 2023). A recent scoping review indicated approximately a dozen studies using SNA in nursing; various connection types including advice seeking, support, communication, and friendship ties were described (Saatchi et al., 2023). Few studies have explored the correlations between communication patterns of subgroups of nurses and specific patient outcomes, such as patient falls, medication errors (Brewer et al., 2018; Effken et al., 2011), hospital‐acquired pressure ulcers (Brewer et al., 2018), and patient satisfaction (Effken et al., 2011).…”

“…Analysis of communication networks may provide insight into EBP adoption, including reasons for success or failure (Pow et al., 2012). Interest in SNA in health care has increased since the early 2000s (Glegg et al., 2019); however, its use in nursing studies has been limited (Kantek et al., 2022; Saatchi et al., 2023). A recent scoping review indicated approximately a dozen studies using SNA in nursing; various connection types including advice seeking, support, communication, and friendship ties were described (Saatchi et al., 2023).…”

Common pitfalls, and how to avoid them, in child and adolescent psychopharmacology: Part II

“…Effective prescribing therefore requires reassurance that weight gain will not escalate over and above that expected for the standard treatment approach (typically eating disorders focussed family therapy) and that the purpose of the medication is to moderate emotional arousal associated with the first phases of treatment to manageable levels, without inducing somnolence. This is based on the sedative, anxiolytic and mood-regulating effects of antipsychotics, which may enable them to reduce obsessive ideas and anxiety, improving mood stability (Thorey et al, 2023).…”

A blueprint for a new commercial driving epidemiology: An emerging paradigm grounded in integrative exposome and network epistemologies

“…While delineating the architecture of ordinary graphs—exemplified by pairwise node interactions represented by edges—has generated valuable insights in understanding and preventing health and safety risks, 101–103 it also comes with inherent constraints 104 . Like other complex networks (e.g., neural or metabolic systems), the multifactorial and multilayered nodes of this CANoN (i.e., the complex network of commercial drivers' health and safety risks) are anticipated to interact in larger groups and such interactions cannot be decomposed as linear combinations of dyadic couplings 105 .…”