Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, P,O, Box 9101, 6500 HB, Nijmegen, the Netherlands.
Implement Sci. 2010 Jan 22;5:3. doi: 10.1186/1748-5908-5-3.
Information exchange networks for chronic illness care may influence the uptake of innovations in patient care. Valid and feasible methods are needed to document and analyse information exchange networks in healthcare settings. This observational study aimed to examine the usefulness of methods to study information exchange networks in primary care practices, related to chronic heart failure, diabetes and chronic obstructive pulmonary disease.
The study was linked to a quality improvement project in the Netherlands. All health professionals in the practices were asked to complete a short questionnaire that documented their information exchange relations. Feasibility was determined in terms of response rates and reliability in terms of reciprocity of reports of receiving and providing information. For each practice, a number of network characteristics were derived for each of the chronic conditions.
Ten of the 21 practices in the quality improvement project agreed to participate in this network study. The response rates were high in all but one of the participating practices. For the analysis, we used data from 67 health professionals from eight practices. The agreement between receiving and providing information was, on average, 65.6%. The values for density, centralization, hierarchy, and overlap of the information exchange networks showed substantial variation between the practices as well as between the chronic conditions. The most central individual in the information exchange network could be a nurse or a physician.
Further research is needed to refine the measure of information networks and to test the impact of network characteristics on the uptake of innovations.
慢性病护理信息交换网络可能会影响患者护理创新的采用。需要有效的、可行的方法来记录和分析医疗环境中的信息交换网络。本观察性研究旨在检验用于研究初级保健实践中与慢性心力衰竭、糖尿病和慢性阻塞性肺疾病相关的信息交换网络的方法的有用性。
该研究与荷兰的一个质量改进项目相关联。要求所有实践中的卫生专业人员填写一份简短的问卷，记录他们的信息交换关系。可行性是根据响应率来确定的，可靠性是根据接受和提供信息的报告的互惠性来确定的。对于每种情况，为每个慢性疾病的每个实践都得出了一些网络特征。
在质量改进项目的 21 个实践中，有 10 个同意参与该网络研究。除了一个参与实践外，所有参与实践的响应率都很高。在分析中，我们使用了来自 8 个实践中的 67 位卫生专业人员的数据。接收和提供信息之间的一致性平均为 65.6%。信息交换网络的密度、集中化、层次结构和重叠的数值在实践之间以及在慢性疾病之间都有很大的差异。信息交换网络中最中心的个体可以是护士或医生。
需要进一步研究来改进信息网络的衡量标准，并检验网络特征对创新采用的影响。
