Network Analysis Examining Intrahospital Traffic of Patients With Traumatic Hip Fracture

Abstract

Introduction:Increased intrahospital traffic (IHT) is associated with adverse events and infections in hospitalized patients. Network science has been used to study patient flow in hospitals but not specifically for patients with traumatic injuries.Methods:This retrospective analysis included 103 patients with traumatic hip fractures admitted to a level I trauma center between April 2021 and September 2021. Associations with IHTs (moves within the hospital) were analyzed using R (4.1.2) as a weighted directed graph.Results:The median (interquartile range) number of moves was 8 (7-9). The network consisted of 16 distinct units and showed mild disassortativity (-0.35), similar to other IHT networks. The floor and intensive care unit (ICU) were central units in the flow of patients, with the highest degree and betweenness. Patients spent a median of 20-28 hours in the ICU, intermediate care unit, or floor. The number of moves per patient was mildly correlated with hospital length of stay (ρ = 0.26, p =.008). Intrahospital traffic volume was higher on weekdays and during daytime hours. Intrahospital traffic volume was highest in patients aged <65 years (p =.04), but there was no difference in IHT volume by dependent status, complications, or readmissions.Conclusions:Network science is a useful tool for trauma patients to plan IHT, flow, and staffing.