While heart attack care has improved dramatically in the past few years, the use of online networks to foster communication and exchange information has played a minor role in this success, new research by the Yale School of Public Health has found.
The Door-to-Balloon (D2B) Alliance—a national campaign which sought to reduce the time in which heart attack patients receive lifesaving treatment upon entering the emergency room—has resulted in hundreds of hospitals nationwide markedly reducing treatment times—and saving lives— through a variety of strategies.
But the use of a campaign-sponsored online community by staff at participating hospitals has played a negligible role in this success. Researchers surveyed the member hospitals and analyzed their online postings for content and usage patterns to determine the effect on their D2B outcomes.
Although 62 percent of the D2B users reported that the online community helped their quality improvement efforts, the network’s impact on treatment times was statistically insignificant. “This suggests that the benefits are intangible or not directly linked to performance. For example, it may be that a key benefit of learning networks is social support, which may not directly translate into performance improvement, yet is valued by participants,” said lead author Ingrid Nembhard, an assistant professor at the School of Public Health and the School of Management. “Our study suggests that more research is needed to understand the scope of benefits that users derive from online communities.”
The research appears in this month’s issue of the journal Quality and Safety in Healthcare.
The online community was primarily used to find information, receive advice on implementing evidence-based practices into hospital settings, and learn how to measure performance and motivate staff. Nine percent of the users were physicians, 70 percent were nurses and the rest were mostly allied professionals and non-clinical staff. Fifty-two percent of the hospitals that participated in the D2B Alliance used the online network, which is considered significant compared to 10 percent estimated participation for online communities in non-healthcare settings. Thus, “Online communities, also used in social marketing, may become central to the diffusion of best practices in health care,” said senior author Elizabeth Bradley, professor in the division of Health Policy and Administration.
“Our findings imply that access to a peer network was particularly valued by nurses who are more involved in improvement activities than physicians. Nurses serving as a conduit for information is potentially beneficial because they work at the frontline of care where the information must be implemented. However, the lower professional status of nurses may limit their ability to enact change in less receptive institutions,” said Nembhard.
Nembhard’s research focuses on organizational learning in health care, with an emphasis on understanding the effects of intra- and inter-organizational relationships, leadership behavior, team learning strategies and project management on quality improvement efforts and clinical outcomes.
Other Yale researchers involved in this study include Alexander Nazeem, Tashonna Webster, Yongfei Wang, Harlan Krumholz and Elizabeth Bradley.