Network analysis of patient flow in two UK acute care hospitals identifies key sub-networks for A&E performance

Abstract

The topology of the patient flow network in a hospital is complex, comprising hundreds of overlapping patient journeys, and is a determinant of operational efficiency. To understand the network architecture of patient flow, we performed a data-driven network analysis of patient flow through two acute hospital sites of King’s College Hospital NHS Foundation Trust. Administration databases were queried for all intra-hospital patient transfers in an 18-month period and modelled as a dynamic weighted directed graph. A ‘core’ subnetwork containing only 13–17% of all edges channelled 83–90% of the patient flow, while an ‘ephemeral’ network constituted the remainder. Unsupervised cluster analysis and differential network analysis identified sub-networks where traffic is most associated with A&E performance. Increased flow to clinical decision units was associated with the best A&E performance in both sites. The component analysis also detected a weekend effect on patient transfers which was not associated with performance. We have performed the first data-driven hypothesis-free analysis of patient flow which can enhance understanding of whole healthcare systems. Such analysis can drive transformation in healthcare as it has in industries such as manufacturing.

A Novel Approach of Modelling Acute Patient Care Across a Healthcare System Using Network Analysis: Effects of The SARS Cov2 Pandemic On Patient Movement

“…This provides a method of visualization of the system of interest, allowing investigation of both its structure and function. The methodology has been used in a range of healthcare settings 8 , for example, to model disease outbreaks 9 , patient referral networks 10 , patient movement through acute care units 11,12 and resource utilization by emergency surgery patients 13 .…”

Can network science reveal structure in a complex healthcare system? A network analysis using data from emergency surgical services

“…Recent papers used these methods in the medical services field to assess the structure of referral systems,15 surgical care teams9 and patterns of acute hospital admissions 16. We wanted to assess whether we could apply network methodology to patient pathways throughout the hospital, specifically emergency surgical admissions and to gain insight into the characteristics and vulnerabilities in our service.…”

Análise de redes na regulação do tratamento do câncer do aparelho digestivo

“…Pesquisas recentes têm utilizado ARS em saúde, investigando a existência de ligações preconizadas, ou não, entre os componentes da rede de atenção, para a avaliação de programas e estratégias de atenção à saúde, com resultados promissores 10,11 . Esse tipo de análise amplia a compreensão acerca do cenário real onde são implementados e desenvolvidos os programas e as ações de saúde 12 .…”