Professional networks and EBM use: A study of inter-physician interaction across levels of care

Spatial effects in hospital expenditures: A district level analysis

“…Finally, also the spread of medical knowledge may differ across medical specialties as it is affected by professional networks (Mascia, Dandi, & Di Vincenzo, 2014). Some areas are characterised by fairly uniform practices because of the leadership exerted by prominent key players or by agreed clinical guidelines.…”

How the study of networks informs knowledge translation and implementation: a scoping review

“…[7]DyadPairwise relations between actors [7]Represents one of three levels of analysis for social network data (the others being individual node-level and whole network level) [7]Centralization Whole network centralization (3)Extent to which interconnections are unequal across the network [21] (i.e., concentrated around one or more central individuals) [7]Thought to enhance ease of knowledge sharing and to promote standard practices of existing protocols [80]. Decentralization may support new innovations, but lead to mixed messaging and decreased clarity because of multiple information sources [72]Centrality Degree centrality (3)# of direct ties (connections) of an actor Seen as an indicator of visibility [81], prestige [39] or power [79] resulting from lots of direct contact to many others Indegree centrality (10)# of individuals who send (identify) ties to an actorConsidered an index of importance [28] power or influence [40] Outdegree centrality (5)# of direct ties an actor sends (identifies) to others [33]Used to quantify access to resources through colleagues, exposure to evidence and others’ practices; positively associated with EIP use [33] Betweenness centrality (4)Extent to which an individual is tied/connected to others who are not connected themselves [40]Used as a proxy for control of KT processes [39]; high values reflect a favorable position (e.g. brokering potential) [40] for information flow or power [79] Flow betweenness centrality (3)How involved an actor is in all of the paths or routes between all other actors (not just those representing the shortest paths) [79]Used to determine contributions of individuals toward team decision-making; provides insights into structural hierarchy [33] Used as a proxy for ease of bypassing the core individuals in the network [39, 79] Closeness centrality (2)Proportion of actors that can be reached in one or more steps [79]Proxy for degree of access to information [39] or efficiency in communicating with the network (relative reach) [7] Bonacich centrality (1)Extent to which an actor is tied to others, weighted according to the centrality (e.g., popularity, importance) of those to whom the actor is tied/connected [79]Proxy for power or hierarchy within a network; may help to identify network fragmentation/brokering opportunities […”

“…Decentralization may support new innovations, but lead to mixed messaging and decreased clarity because of multiple information sources [72]Centrality Degree centrality (3)# of direct ties (connections) of an actor Seen as an indicator of visibility [81], prestige [39] or power [79] resulting from lots of direct contact to many others Indegree centrality (10)# of individuals who send (identify) ties to an actorConsidered an index of importance [28] power or influence [40] Outdegree centrality (5)# of direct ties an actor sends (identifies) to others [33]Used to quantify access to resources through colleagues, exposure to evidence and others’ practices; positively associated with EIP use [33] Betweenness centrality (4)Extent to which an individual is tied/connected to others who are not connected themselves [40]Used as a proxy for control of KT processes [39]; high values reflect a favorable position (e.g. brokering potential) [40] for information flow or power [79] Flow betweenness centrality (3)How involved an actor is in all of the paths or routes between all other actors (not just those representing the shortest paths) [79]Used to determine contributions of individuals toward team decision-making; provides insights into structural hierarchy [33] Used as a proxy for ease of bypassing the core individuals in the network [39, 79] Closeness centrality (2)Proportion of actors that can be reached in one or more steps [79]Proxy for degree of access to information [39] or efficiency in communicating with the network (relative reach) [7] Bonacich centrality (1)Extent to which an actor is tied to others, weighted according to the centrality (e.g., popularity, importance) of those to whom the actor is tied/connected [79]Proxy for power or hierarchy within a network; may help to identify network fragmentation/brokering opportunities [14] Hubs and authorities centrality (1)The structural prominence of individuals within a core-periphery structured network [32]Proxy for importance [32]Tie characteristics Tie strength (7)Value associated with a tie/connection, e.g., frequency of contact, emotional intensity, duration of connection, etc. [7]Weak ties thought to increase access to new information/opportunities; strong ties seen as required for innovation implementation [82] Tie homophily (includes external-internal...…”

Determinants of knowledge-sharing networks in primary care

“…In addition, the epidemiological trends significantly affect primary care physicians because, in contrast to specialists, they (are assumed to) always embrace "long-term person-(not disease) focused care" and to focus on comprehensive care for most health needs (Starfield et al, 2005, p. 458). Moreover, the working conditions of primary care physicians, who are often scattered throughout a territory, are not optimal for knowledge sharing and integration (Mascia et al, 2014). Along these lines, policy-makers are becoming increasingly attentive and active in fostering integration in primary care (Fantini et al, 2011;Fattore et al, 2009;YousefiNooraie et al, 2014).…”

“…One of the most effective coordination mechanism is represented by physicians' knowledgesharing networks, which involve the establishment of direct relationships aimed at the exchange of advice, opinions, and information between two or more physicians (Mascia et al, 2014;Paul et al, Determinants of Knowledge-sharing Networks in Primary Care 4 2014; Rangachari 2008;Zappa, 2011). As Keating et al state, "physicians often rely on colleagues for new information to help them interpret the medical literature, and to obtain specific advice about the care of their patients " (2007: 794).…”