JMIR Publications

ABSTRACT

Background:

Clinical practice variation that result in poor patient outcomes remains a pressing problem for healthcare organizations. Some evidence suggests that a key factor may be ineffective internal and professional networks that limit knowledge exchange between healthcare professionals. Virtual communities (VC) have the potential to overcome professional and organisational barriers and facilitate knowledge flow.

Objective:

To explore why healthcare professionals belong to an exemplar VC, ICUConnect. The specific research objectives were to: 1) understand why members join and remain a member; 2) identify what purpose the VC serves in in their professional lives; 3) identify how a member uses the VC; and 4) identify how members used the knowledge or resources shared on the VC.

Methods:

A qualitative design, underpinned by Pragmatism, was used to collect data from three asynchronous online focus groups and four key informant interviews with participants allocated to a group based on their posting behaviors during the previous two years - between September 1, 2012 and August 31, 2014: 1) frequent (more than five times); 2) low (five times or less); and 3) non-posters. A novel approach to focus group moderation, based on principles of traditional focus groups, and e-moderating was developed. Thematic analysis was undertaken, applying the Diffusion of Innovations theory as the theoretical lens. NCapture was used to extract data from the online focus groups and NVIVO was used to manage all data. A research diary and audit trail were maintained.

Results:

There were 27 participants: seven frequent posters, 13 low posters, and seven non-posters. All participants displayed an external orientation with the majority using other social media, however, listservs were perceived to be superior in terms of professional compatibility and complexity. The main theme was ‘Intensive care professionals are members of ICUConnect because by being a member of a broader community they have access to credible best-practice knowledge’. The VC facilitated access to all professionals caring for the critically ill and was characterized by a positive and collegial online culture. The knowledge found was credible because it was extensive, and because the VC was moderated and sponsored by a government agency. This enabled members to benchmark and improve their unit practices, and keep up to date.

Conclusions:

This group of healthcare professionals made a strategic decision to be members of ICUConnect, as they understood that to provide up-to-date clinical practices, they needed to network with colleagues in other facilities. This demonstrated that a closed speciality-specific VC can create a broad heterogeneous professional network, overcoming current ineffective networks that adversely impact on knowledge exchange and creation in local practice settings. To address clinical practice variation healthcare organizations can leverage low cost social media technologies to improve inter-professional and – organizational networks. Clinical Trial: not applicable