437. Studying Emerging Infections in Social Networks of Patients and Healthcare Workers in Emergency Departments
Session: Poster Session: Hospital-acquired and Transplant Infections
Friday, October 30, 2009: 12:00 AM
Room: Poster Hall A
Background: Healthcare workers (HCW) interact with patients (Pt) and other HCW in social networks in emergency departments (ED). Improved understanding of these networks may inform mitigation strategies for emerging infections such as novel H1N1 influenza.
Methods: The setting was a large urban tertiary care pediatric ED. Social networks of Pt-HCW and HCW-HCW interactions were constructed by integrating patient tracking information with HCW location data derived from room sensors and infrared badges. Social network analyses were performed to measure Pt-HCW interactions.. Average path length is the average number of relations in the shortest possible walk from one node to the other node in the network. The clustering coefficient is the average of the densities of the neighborhoods of all the members of the network.
Results: Pt-HCW and HCW-HCW interactions in the ED during the month of March 2008 were analyzed. During this period, 1261 patients visited the ED and 87 HCW worked at least one shift. Each patient had contact with an average of three unique HCW (SD= 2) and each HCW had contact with an average of six patients per 12-hour shift (SD = 8). The average path length between a randomly selected Pt and HCW was 2.6; the clustering coefficient of 0.5. Selected HCW were highly connected to patients and other HCW. The pattern of Pt-HCW interactions corresponded to a small-world type of network.
Conclusions: These network properties inform occupational exposures in the ED. Infections with short incubation periods such as novel H1N1 influenza propagate rapidly in small world networks. Highly connected HCW may partially explain the concept of superspreaders. A detailed study of these networks will allow us to develop agent-based models to study transmission dynamics and effect of interventions and mitigation strategies to protect HCW.
Jose Benuzillo, MA, MS1, Richard N Greenberg, MD2, Adi Gundlapalli, MD, PhD, MS1, Joseph Hales, PhD1, Molly Leecaster, PhD, Xiulian Ma, M Stat1, Warren Pettey, MPH, CPH1, Matthew Samore, MD, FSHEA4 and  A. Gundlapalli, None..
X. Ma, None..
J. Benuzillo, None..
W. Pettey, None..
R. Greenberg, None..
J. Hales, None..
M. Leecaster, None..
M. Samore, None., (1)University of Utah, Salt Lake City, UT, (2)Univ. of Kentucky Medical Center, Lexington, KY, (3)University of Utah School of Medicine, Salt Lake City, UT