Network Analysis Examining Intrahospital Traffic of Patients With Traumatic Hip Fracture.

IF 0.9 4区 医学 Q4 HEALTH CARE SCIENCES & SERVICES Journal for Healthcare Quality Pub Date : 2023-03-01 DOI:10.1097/JHQ.0000000000000367
Elizabeth A Secor, David Hamilton, Cecile D'Huyvetter, Kristin Salottolo, David Bar-Or
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Abstract

Introduction: Increased intrahospital traffic (IHT) is associated with adverse events and infections in hospitalized patients. Network science has been used to study patient flow in hospitals but not specifically for patients with traumatic injuries.

Methods: This retrospective analysis included 103 patients with traumatic hip fractures admitted to a level I trauma center between April 2021 and September 2021. Associations with IHTs (moves within the hospital) were analyzed using R (4.1.2) as a weighted directed graph.

Results: The median (interquartile range) number of moves was 8 (7-9). The network consisted of 16 distinct units and showed mild disassortativity (-0.35), similar to other IHT networks. The floor and intensive care unit (ICU) were central units in the flow of patients, with the highest degree and betweenness. Patients spent a median of 20-28 hours in the ICU, intermediate care unit, or floor. The number of moves per patient was mildly correlated with hospital length of stay (ρ = 0.26, p = .008). Intrahospital traffic volume was higher on weekdays and during daytime hours. Intrahospital traffic volume was highest in patients aged <65 years ( p = .04), but there was no difference in IHT volume by dependent status, complications, or readmissions.

Conclusions: Network science is a useful tool for trauma patients to plan IHT, flow, and staffing.

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外伤性髋部骨折患者院内流量的网络分析。
导论:院内交通(IHT)增加与住院患者的不良事件和感染有关。网络科学已被用于研究医院的病人流动,但并不专门用于创伤性损伤患者。方法:本回顾性分析纳入了2021年4月至2021年9月间在一级创伤中心收治的103例外伤性髋部骨折患者。使用R(4.1.2)作为加权有向图分析与iht(医院内活动)的关联。结果:移动次数中位数(四分位数间距)为8(7-9)。该网络由16个不同的单元组成,与其他IHT网络相似,表现出轻微的不协调性(-0.35)。楼层和重症监护病房(ICU)是患者流动的中心单位,其程度和间隔性最高。患者在ICU、中级护理病房或楼层的平均时间为20-28小时。每位患者的移动次数与住院时间轻度相关(ρ = 0.26, p = 0.008)。医院内交通量在工作日和白天较高。结论:网络科学是创伤患者规划IHT、流量和人员配置的有用工具。
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来源期刊
Journal for Healthcare Quality
Journal for Healthcare Quality HEALTH CARE SCIENCES & SERVICES-
CiteScore
2.10
自引率
0.00%
发文量
59
期刊介绍: The Journal for Healthcare Quality (JHQ), a peer-reviewed journal, is an official publication of the National Association for Healthcare Quality. JHQ is a professional forum that continuously advances healthcare quality practice in diverse and changing environments, and is the first choice for creative and scientific solutions in the pursuit of healthcare quality. It has been selected for coverage in Thomson Reuter’s Science Citation Index Expanded, Social Sciences Citation Index®, and Current Contents®. The Journal publishes scholarly articles that are targeted to leaders of all healthcare settings, leveraging applied research and producing practical, timely and impactful evidence in healthcare system transformation. The journal covers topics such as: Quality Improvement • Patient Safety • Performance Measurement • Best Practices in Clinical and Operational Processes • Innovation • Leadership • Information Technology • Spreading Improvement • Sustaining Improvement • Cost Reduction • Payment Reform
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