Measuring Social Network Structure of Clinical Teams Caring for Patients with Complex Conditions

Chronic, complex health conditions require teams that communicate effectively to be able to achieve best outcomes. In this study, we assessed the communication structure using social network analysis (SNA) for three distinct multidivisional teams caring for populations of children who have undergone liver transplantation, have been diagnosed with cerebral palsy or have been diagnosed with intestinal rehabilitation. In most cases, team members were geographically dispersed at the hospital campus, thereby requiring team members to depend on email for much of their communication. We used the Condor Social Network Analysis tool (Condor) to analyze the email communication patterns of team members. In our longitudinal analysis, we measured ties, betweenness centrality, contribution index, and density using social network metrics. Distinct patterns and structures of communications emerge among the teams’ leadership. In the Liver Transplant team and the Intestinal Rehabilitation team, the leaders communicate as a core group. On the other hand, in the Cerebral Palsy team, one of the four leaders assumes a very peripheral position mostly communicating with the partners outside the hospital. Furthermore, other people from outside the Cerebral Palsy team exhibit much higher betweenness centrality. The distinct patterns of communication flow lead us to ask if the Cerebral Palsy team may improve team function through better integration of the team leaders. Based on these initial observations, we think it is likely that SNA of communication patterns can increase the efficiency of team development and enhance team function in geographically dispersed health care teams thereby increasing their effectiveness.