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Network structure and the role of key players in healthcare networks

机译:网络结构和关键参与者在医疗保健网络中的作用

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摘要

Professional networks are being used increasingly in healthcare to overcome problems of working within a system fragmented by professional “tribes,” and organisational and geographic boundaries. Such networks are thought to encourage the bridging of these boundaries, leading to greater collaboration. Research about how this is achieved does not yet give a comprehensive picture of network processes and the role of key actors. This thesis used a combination of qualitative and quantitative methods, primarily social network analysis, to explore the network structure and the role of key players within a representative network. The network was a new translational research network (TRN) based in Sydney, Australia that sought to drive collaboration between university-based researchers and hospital-based clinicians to translate biomedical research into clinical practice. The thesis asked the following questions: what is the structure of collaborative ties within this network? Who are the key players in this network? Do the formal, mandated leaders of this network recognise the potential held in their network positions? TRN documentation, semi-structured interviews with the 14 governing body members, and a systematic review of brokerage roles in collaborative networks gave context, and informed the design of the social network survey. An on-line, whole network survey was used to collect demographic and relationship data from all 68 members in early 2012 as well as opinions on aspects of the network. Geographic location was a significant factor determining patterns of collaboration. Central actors identified by analysis of network data mostly matched members’ perceptions of powerful and influential players but identified brokers were not perceived as such. Mandated leaders were found to have key network positions and recognised their significance in terms of facilitative activities. The thesis shows empirically the influence of “silos” on collaboration and that the network may increase connectivity between them. Secondly it shows the hidden identity of brokers in the healthcare setting. This confirmed that network interventions based on role support for key players can only be realised if the brokers are accurately identified. Thirdly it shows that mandated leaders in the network understand their roles and activities in a way that reflects their network potential.
机译:在医疗保健中,越来越多地使用专业网络来解决在由专业“部落”,组织和地理边界分散的系统中工作的问题。人们认为这样的网络鼓励了这些边界的桥接,从而导致了更大的合作。关于如何实现这一目标的研究尚未全面描述网络过程和关键参与者的角色。本文采用定性和定量方法相结合的方法(主要是社交网络分析)来探讨网络结构和代表性网络中关键参与者的角色。该网络是一个新的转化研究网络(TRN),位于澳大利亚悉尼,旨在推动大学研究人员与医院临床医生之间的合作,以将生物医学研究转化为临床实践。论文提出了以下问题:该网络内的协作关系的结构是什么?谁是这个网络的主要参与者?该网络的正式授权领导人是否认识到其网络职位所具有的潜力? TRN文档,对14个理事机构成员的半结构化访谈,以及对协作网络中经纪人角色的系统评价提供了背景信息,并为社交网络调查的设计提供了依据。在2012年初,使用了一个在线的,整个网络的调查来收集所有68个成员的人口统计和关系数据,以及对网络各个方面的意见。地理位置是决定合作模式的重要因素。通过分析网络数据确定的中央参与者,大多数与成员对强大而有影响力的参与者的看法相符,但与经纪人无关。发现授权的领导者具有重要的网络位置,并认识到其在促进活动方面的重要性。本文从经验上展示了“孤岛”对协作的影响,并且网络可能会增加它们之间的连接性。其次,它显示了医疗机构中经纪人的隐藏身份。这证实了只有在准确识别经纪人的情况下,才能实现基于对关键参与者的角色支持的网络干预。第三,它表明网络中的受命领导者以反映其网络潜力的方式了解他们的角色和活动。

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