Dossier n. 241/2014 [Abstract] Many networks, many paradigms: network analysis in healthcare

The report collects information and experiences related to some projects “Continuity of care: implementation of clinical-organizational models” (2007-2008), “Multidimensional assessment of elderly patients: Applying tools to evaluate continuity of care” (2008-2009), “Management of high territorial impact chronic diseases according to the chronic care model, in order to reduce disability, the inappropriate use of hospitalization, and to improve patients’ and caregivers’ quality of life” (2009-2010) realized by the Regional Agency for Health and Social Care of Emilia-Romagna.

Connected to these works, the project for network analysis of care was started in November 2011.

In this report tools and methods are presented which can be used by health care professionals.

The report is divided into three Parts and 11 Chapters.

The first Part (from Chapter 1 to Chapter 5) deals with concepts and indicators of network analysis that describe and give a graphic representation of clinical and organization networks. Examples of some Italian researches on health care system and networks are given, and the map of networks of care for elderly chronic patients in some Health Trusts of Emilia-Romagna are analyzed. In this research different tools are used: flowchart, ego-network pattern, exchanges and transactions tables. Each participant, a professional of the health care system, makes a picture of his network of care, the main connections and the characteristics such as dimensions, density and centralization. Through the map, all professionals can develop a better awareness of their different roles in network functioning.

The second Part (from Chapter 6 to Chapter 8) illustrates the main theories and tools for analysis of networking, the process of functioning, communication and cooperation, operation mechanism and relevant skills for networks of care.

The third Part (Chapter 9 and 10) focuses on the workshops of November 2011 with the same professionals of health care for elderly chronic patients of the first Part. They worked on three different problems (stroke, femur fracture and dementia) with the same method (case analysis and networking analysis), in order to understand the characteristics of network connections and interdependence in Chronic Care Model for the continuity of care.

The Conclusions (Chapter11) highlight the importance of care networks continuity in health care organizations and present more projects of the Regional Agency for Health and Social Care dealing with the paradigm of network analysis.