Social networking by doctors may save patients’ lives, study suggests
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A new study finds that heart surgery patients' chances of survival depends in part on the overall level of teamwork among all the physicians who cared for them across their surgery preparation, operation, hospitalization and recuperation.
The finding was made by a team of researchers at the
Using data from 251,000 older Americans who had heart bypass surgery, they mapped the interactions among the 466,000 doctors who cared for them, and show the importance of tight "social networks" of physicians to patient outcomes.
They've published their results in the new issue of Circulation: Cardiovascular Quality and Outcomes, and hope to test their model in other conditions and by considering other types of providers beyond physicians. They're already studying the effect further, using anthropology research techniques in the
"Surgical care is complex, involving multiple providers dispersed across locations over time," says
The more often their physicians worked with one another in the past on the care of other patients, the lower their current patients' chances were of ending up in the emergency department or hospital, and their chances of dying, within the first two months after their operation.
The researchers created their model of physician teamwork based on
The results were striking. A 25 percent increase in the measure of teamwork was associated with 17 fewer readmissions for every 1,000 patients treated.
That's only slightly less impact than a similar-size increase in a measure of education in that same regional community; higher levels of education are already known to be associated with better surgical results. A 25 percent increase in a measure of how complex and sick patients are - called a Charlson score -- only accounted for one extra readmission per 1,000 patients.
Hollingsworth and his colleagues, including senior author and U-M cardiologist Brahmajee Nallamothu, M.D., MPH, note that regions varied widely in their teamwork 'score'. To illustrate, their paper shows a map of ties among physicians who treated patients who had their operations in 2011 in two Texas hospitals 90 miles apart -- one in
The measure of teamwork among all the physicians who treated these patients across the eight-month span surrounding their operation was nearly five times higher among
The teamwork effect persisted no matter how large or small the number of bypass operations performed at a given hospital, or the type of hospital. Large academic medical centers tended to have lower teamwork scores because they receive far more patients who are referred to them from physicians far outside their local area who they don't work with often. This may help explain why those hospitals don't always score high on
"A lot of the focus in improving care is focused on the acute hospitalization for an episode of care. We believe that this focus is too myopic because it ignores the care delivered prior to the hospital stay and after discharge," says Hollingsworth. "Efforts to improve teamwork, and outcomes, need to consider the entire care continuum."
Hollingsworth and Nallamothu are both members of the
The researchers are now hoping to look at other data from
Keywords for this news article include: Surgery, Hospital, Health Policy,
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