期刊文章在COVID-19大流行之前和期间评估新生儿重症监护病房结构和卡塔尔世界杯8强波胆分析结果:网络分析研究%A Mannering,Hannah %A Yan,Chao %A Gong,Yang %A Alrifai,Mhd Wael %A France,Daniel %A Chen,You %+范德比尔特大学医学中心生物医学信息系，2525 West End Ave, Suite 1475，田纳西州纳什维尔，37203，美国，1 6153431939，you.chen@vanderbilt.edu %K新生儿重症监护病房%K协作%K卫生保健组织结构%K重症监护%K住院时间%K出院安排%K电子健康记录%K网络分析%K COVID-19 %K时间网络分析%D 2021 %7 20.10.2021 %9原始论文%J J医学互联网研究%G英语%X背景:卫生保健组织(HCOs)采用策略(例如:医疗保健组织(HCOs)。保持身体距离)，以在COVID-19大流行期间保护重症监护病房(ICUs)的临床医生和患者。许多在COVID-19大流行前进行的实际护理活动在大流行期间已过渡到虚拟系统。这些转变可能会干扰ICU的协作结构，从而影响临床结果。理解这些差异可以帮助HCOs在后covid -19时代将实体协作过渡到虚拟环境时识别挑战。目的:本研究旨在利用网络分析方法确定新生儿重症监护病房(NICU)合作结构从新冠肺炎疫情前到新冠肺炎疫情内的变化。方法:在这项回顾性研究中，我们将网络分析应用于712例危重新生儿(covid -19前，n=386;2019年9月1日至2020年6月30日期间，在范德比尔特大学医学中心新生儿重症监护室住院的新冠肺炎患者(n=326例，不包括新冠肺炎患者)，以评估临床医生之间的合作。 We characterized pre–COVID-19 as the period of September-December 2019 and intra–COVID-19 as the period of March-June 2020. These 2 groups were compared using patients’ clinical characteristics, including age, sex, race, length of stay (LOS), and discharge dispositions. We leveraged the clinicians’ actions committed to the patients’ EHRs to measure clinician-clinician connections. We characterized a collaboration relationship (tie) between 2 clinicians as actioning EHRs of the same patient within the same day. On defining collaboration relationship, we built pre– and intra–COVID-19 networks. We used 3 sociometric measurements, including eigenvector centrality, eccentricity, and betweenness, to quantify a clinician’s leadership, collaboration difficulty, and broad skill sets in a network, respectively. We assessed the extent to which the eigenvector centrality, eccentricity, and betweenness of clinicians in the 2 networks are statistically different, using Mann-Whitney U tests (95% CI). Results: Collaboration difficulty increased from the pre– to intra–COVID-19 periods (median eccentricity: 3 vs 4; P<.001). Nurses had reduced leadership (median eigenvector centrality: 0.183 vs 0.087; P<.001), and neonatologists with broader skill sets cared for more patients in the NICU structure during the pandemic (median betweenness centrality: 0.0001 vs 0.005; P<.001). The pre– and intra–COVID-19 patient groups shared similar distributions in sex (~0 difference), race (4% difference in White, and 3% difference in African American), LOS (interquartile range difference in 1.5 days), and discharge dispositions (~0 difference in home, 2% difference in expired, and 2% difference in others). There were no significant differences in the patient demographics and outcomes between the 2 groups. Conclusions: Management of NICU-admitted patients typically requires multidisciplinary care teams. Understanding collaboration structures can provide fine-grained evidence to potentially refine or optimize existing teamwork in the NICU. %M 34637393 %R 10.2196/27261 %U //www.mybigtv.com/2021/10/e27261 %U https://doi.org/10.2196/27261 %U http://www.ncbi.nlm.nih.gov/pubmed/34637393