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J Interprof Care. 2018 Aug 29:1-8. doi: 10.1080/13561820.2018.1515193. [Epub ahead of print]

Networks of hospital discharge planning teams and readmissions.

Author information

1
a Department of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA.
2
b Center for Clinical Quality and Implementation Research , Vanderbilt University Medical Center , Nashville , TN , USA.
3
c Department of Neurology , Brigham and Women's Hospital, Harvard Medical School , Boston , MA , USA.
4
d Network Science Institute , Northeastern University , Boston , MA , USA.

Abstract

Improving the hospital discharge process to prevent readmission requires a focus on the coordination and communication between interprofessional team members in and outside of the hospital as well as with patients and their caregivers. Yet little is known about how these actors currently communicate and coordinate during the discharge process. Network analysis allows for a direct look at this communication and coordination. This network analysis study utilized retrospective chart review to identify the individuals involved in the discharge planning and their communication with each other for 205 patients. Using this abstracted data, a network was created for each patient wherein a node was any individual involved in the patient's discharge planning process and a tie was any communication documented in the chart related to discharge planning between individuals. Graphical and structural network analyses were used to compare the networks of readmitted patients and non-readmitted patients. Networks of patients not readmitted were more hierarchical, unidirectional, streamlined compared to those readmitted. These findings demonstrate the feasibility and usefulness of conceptualizing discharge planning as a network. Future efforts to understand discharge planning and create interventions to improve the process may benefit by considering network patterns of communication.

KEYWORDS:

Communication; discharge planning; healthcare teams; network analysis; readmissions

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