Social Network Analysis and Relational Coordination: Empowering Nurse Administrators Leading Care Coordination Teams to Assess Improvement Opportunities

Objective: – To explore cross-sector collaboration in complex care transition planning by care coordinators through discussion of a hypothetical practice application and recent research application of social network analysis and relational coordination. Background: – With growing evidence showing the impact of health-related social needs on patient outcomes, funding and regulatory agencies demand care models that link health and social organizations. Programs like medical respite for people experiencing homelessness rely on cross-sector collaboration, the structured alliance of multiple agencies to manage a complex problem unable to be met by one entity, to ensure successful transitions after hospitalization. In cross-sector scenarios, nurse administrators oversee frontline care coordinators, facilitating transitional care plans that can be labor-intensive and require an interorganizational strategy to maneuver and optimize. Methods: – A discussion of social network analysis and relational coordination was applied to a hypothetical hospital care coordinator practice scenario. A recent research application study of a medical respite program and its collaborating cross-sector network (N=15 health/social organizations) through 21 administrative interviews and 41 frontline care coordinator surveys was reviewed. Cross-sector collaboration in the research application study was measured by analysis of the frequency of collaboration between agencies (social network analysis) and the quality of relationships and communication (relational coordination). Results: – Elements and practical application of social network analysis and relational coordination were discussed. Research application results showed that administrative participants were more collaborative than the frontline. All rated relationship quality higher than communication quality. Homeless service and acute care agencies were central actors in the cross-sector network. Conclusions: – The authors describe an innovative way to measure and optimize cross-sector collaboration in teams coordinating complex care transitions. This model could be used by nurse administrators designing or managing cross-sector collaborative programs with community partners receiving patients at high-risk for readmission after hospital discharge, like people experiencing homelessness with multimorbid clinical needs, and adds to the growing literature on an innovative care concept known as cross-sector care coordination.