Social network analysis on hospital logistics

In the past weeks I have been wondering what the next blog could be about. I have been working on social networks over summer and there is (too) much to say about that and at the same time I have questions on how to use these networks. I could probably blog 60 pages easily but that is not the idea of a paper, let alone a blog. So here I will just start with something.

In the figure below you can see what I found in the case study research with regard to the interaction required for tactical planning of resources required for surgery patients. Every node is a person and every tie represents some kind of communication taking place – either verbally, by email, telephone, whatsapp – between the two nodes. It’s a qualitative model, in the sense that ties do not represent communication frequency. I colored every person according to the organizational unit they belong to. Red is Operating Theatre (OT), blue is medical staff, green and purple are a care departments. There are 134 nodes and 875 unique ties in this network.SNA tact planThere are five tasks in this planning phase; making the OT schedule is the most important one since all other tasks depend on this schedule. In the OT schedule the time slots and operating rooms are allocated to nine medical disciplines. The OT schedule is the result of a collaboration between the OT capacity planner, OT manager, two cluster managers and surgeons from medical discipline and an anesthetist. In the social network this is visible right in de middle. Around the middle various groups of people are visible; these are the surgeons of each medical discipline and the group of anesthaesists. They make their own working schedule, in collaboration with with the secretary of the outpatient department they belong to. Other derivatives of the OT schedule are the OT nurse schedule (visible on the top left) and the clinical bed plan.

Different people probably see different things in the image. What I see is that the OT capacity planner (OTPLAN) is central to the entire tactical planning. Without this one person, not all subsystems who perform a subtask, would be connected. The surgeons who represent their medical discipline group and the anesthetist also clearly have an integrative role in this planning phase.

A measure used in social network analysis for this is ‘Betweenness centrality’. It is a measure for how important a node is in providing a “bridge” between different parts of the network. It highlights the nodes that, if removed, would cause a network to fall apart.  Interestingly enough management plays a less central role in this network than the surgeons and the capacity planner. The top 10 of people with highest betweenness centrality are (1) OT capacity planner, (2) the OT team leader, (3) the OT day coordinator followed by the anesthaesist and surgeons who participate in the process of making the OT schedule.

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