~2010~
Presentation
3 Minutes Thesis Competition
The University of Auckland
Thursday September 2, OGGB Case Room 2 (Level 0)
Heat Four: FMHS, Science 1-5pm
Poster
24th Annual Australian and New Zealand academy of
management conference.
Adelaide, Australia
~2011~
Poster
School of Population Health
The University of Auckland
Research Showcase 2011
Thursday 1 December ● Function Hall 730-220 and Atrium
~2012~
Global Health Conference. Singapore.
Social relations: interprofessional networks and influence on integrated care
- Proceedings of the Annual International Conference on Global Healthcare Singapore (GHC 2012)
- August 2012
Authors: Nelson Aguirre, Peter Carswell, Timothy Kenealy
Several studies in recent years have demonstrated the relationship between the structure of interactions between people and the impact that this has on the achievement of goals. However, in the field of health systems this is an issue still to be studied. Chronic care programs in developed countries seek greater integration and communication between health professionals to improve health outcomes. But more empirical evidence is needed to assess the degree of integration and how the information influences those who are involved in these programs. This paper analyzes the way in which health workers interact at the primary and secondary care interface, based on integrated care design in a program of chronic care in New Zealand. The frequency, quality and perceived value of the ties between general practitioners, practices nurses, medical specialists and specialist nurses are used as explanatory variables in graphical models which take a social network analysis approach. The paper shows the configuration of the network between health professionals in an integrated care context, and explains the academic and policy implication of the findings.
HEALTHEX 2012. THE UNIVERSITY OF AUCKLAND
HealtheX, the student organised conference
promoting research contributions of
undergraduate and postgraduate students was
held at Grafton campus on Friday 7th September,
and SoPH was well represented by eleven students
selected to give oral presentations on the day.
Health Systems: Nelson Aguirre, Social relations:
interprofessional networks and influence on integrated
care. (Supervisor: Peter Carswell & Tim Kenealy)
~2013~
Conference Paper:
How might inter-professional networks overcome clinical inertia at the primary and secondary care interface?
AGUIRRE Nelson, CARSWELL Peter and KENEALY Tim. School of Population Health. The University of Auckland. PB 1072, New Zealand.
Background: Failure to intensify treatment when it is needed contributes to illness complications, particularly in non-communicable diseases such as diabetes. Recently, scholars have begun to pay more attention in the potential of the inter-professional relationship between general practitioners and specialists, to improve outcomes, via attention to the effects on prescribing practices. However, more empirical research is needed.
Objective: the goal of this study was to explore inter-professional network factors associated with influence on prescription changes. The results of this study allow understanding of how links between health professionals at the primary and secondary care interface help to avoid clinical inertia.
Methods: A qualitative study was conducted in a diabetes integrated care program in New Zealand. Data was collected through semi-structured interviews from 16 health practices and a hospital diabetes clinic, using a convenience sample of general practitioners and endocrinologists. A qualitative content analysis and conceptual mapping were performed to identify factors underlying networks and effects on patient outcomes.
Results: Six factors emerged: collaboration, communication, knowledge transfer, successful adoption to new changes, coordination and innovation adoption. Collaboration and communication were the major themes. These demonstrated the need for building effective channels of communication to share experience and knowledge in timely diabetes care.
Conclusions: Reducing clinical inertia is one mechanism to improve patient outcomes in non-communicable diseases. Intensifying or changing therapy is a physician’s behaviour. Communication and better collaboration are critical factors to influence this behaviour within primary and secondary care.
Poster:
Gender preference for health information and advice interactions
AGUIRRE Nelson, CARSWELL Peter and KENEALY Tim. School of Population Health. The University of Auckland. PB 1072, New Zealand.
Background: Scholars are interested in how social network’s characteristics may influence communication and outcomes. Homophily refers to the similarity of people’s characteristics such as gender, profession and age within a network. Numerous studies have shown the prevalence of gender-based similarity affects the interactions in organizational contexts. However, studies in the health care arena have shown contradictory findings.
Objective: The goal of this paper is to describe gender homophily in an inter-professional network comprising the primary and secondary care interface in diabetes care.
Methods: A Social Network Analysis was conducted in a with primary and secondary care clinicians responsible for diabetes care in Auckland New Zealand. Two different methods were used to test gender affinity in 40 health professionals (GPs, endocrinologist and specialist nurses). First, a metric analysis of homophily ranking corrected for potential differences in gender proportions was conducted. Second, a linear regression tested predictors of homophily ranking.
Results: Homophily ranking is scored between -1 (perfect heterophily) and 1 (perfect homophily). Results from the first method found gender homophily was close to 0, indicated that network members were likely to interact with males and females without preferences. Not surprisingly, the regressions found that gender was not statically associated with homophily ranking.
Conclusions: This study in diabetes care network found little evidence to support the impact of gender homophily on communication exchange. This contrasts with other studies in health care context. Other influences need to be explorer at this context.
Paper accepted and published in conference proceeding
Measuring Inter-Professional Integration and Influence
on integrated care. A Social Network Approach
Background:
Chronic
care programs in developed countries seek greater integration and communication
between health professionals to improve health outcomes. But more empirical
evidence is needed to assess the degree of integration and how the information
influences those who are involved in these programs.
Objective:
This
paper analyses the way in which health workers interact at the primary and
secondary care interface, based on integrated care design in a program of
chronic care in New Zealand.
Methods:
Interactions
between general practitioners, practices nurses, medical specialists and
specialist nurses were used as explanatory variables in graphical models which
take a social network analysis approach.
Results:
The
paper shows the configuration of the network between health professionals in an
integrated care context.
Conclusions:The application of the social network perspective in healthcare context,
particularly at the primary and secondary care interface is one of the
contributions of this study. Social Network Analysis could be a useful tool to
measure levels of integration at the integrated care programs. Managers, policy
makers and staff could use this approach for the purpose of measure the
structure and dynamic of the inter-professional networks.
Key Words: Integrated care, Measuring Integration,
Social Network Analysis, Inter-professional networks.
Paper conferece accepted for oral presenttion.
Association between
inter-professional networks at the primary and secondary care interface and primary
care physician prescription behaviours
ABSTRACT: Patterns of interaction between health professionals
might influence physician prescribing patterns in chronic care management. This
study explored how patterns of interaction between health professionals were
associated with appropriate intensification of therapy. The setting was general practices and a large
teaching hospital in Auckland New Zealand. Two methods were used: first, Social
Network Analysis was used to identify network characteristics and patterns of
interaction and second, multi-linear regression was used to identify how social
network characteristics might predict intensification of therapy behaviour in
general practitioners. The results confirmed strong advice and influence from
secondary to primary care. There was a statistically significant association
between more appropriate intensification of therapy by those general
practitioners with more secondary care interactions.
Keywords: Choice behaviour, communication, decision making, group dynamic,
interpersonal behaviour, work performance.
