The nature and value of healthcare professional virtual communities : an exploration of the ICUConnect listserv

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Current organisational structures and cultures limit the social networks of healthcare professionals (HCPs) who facilitate translation of evidence into practice and consistency of patient care standards. ICUConnect, a listserv for intensive care clinicians, was explored as an exemplar to evaluate whether HCP virtual communities (VC) facilitate knowledge and clinical expertise exchange within a broader professional social network. A series of studies using multiple methods, underpinned by the Diffusion of Innovations and Community of Practice (CoP) theories, was conducted to address the thesis aim, focusing on ‘who’, ‘what’ and ‘why’ of VC membership and activity. An integrative review (1990-2015) of findings from 72 studies demonstrated that HCPs primarily used VCs to exchange domain specific experiential knowledge with colleagues in their clinical specialty. Reliance on readily available data however meant that the perspective of the non-posting majority of users had not been explored. A retrospective descriptive study of ‘who’ belonged to the social network revealed that 78% (n=1042/1340) of HCPs who joined remained members, with ‘ICUConnect’ evolving from a single state nurse-specific network to an Australian-wide multi-disciplinary and multi-organisational intensive care network. A retrospective qualitative descriptive study explored the nature of ‘what’ knowledge was exchanged. Over ten years (2004-13) 133 members from 80 organisations posted 326 emails in the 40 discussion threads with nurses in clinical leadership roles contributing 55% of data. Knowledge exchanged was categorised as: experiential (34%); experiential and explicit (20%); explicit (21%); know-how (20%); know-why (5%); no knowledge (6%). Thematic analysis revealed the central construct of virtual community work with six elements identified that worked synergistically to develop a collegial professional online environment, reflecting the activities of a virtual CoP. A naturalistic qualitative study developed an understanding of ‘why’ HCPs belong to the VC. Twenty-three members participated in three asynchronous online focus groups (frequent-posters: 3; low-posters: 13; non-posters: 7) and four frequent posters were interviewed. The major emergent theme was that these participants joined and remained members because this broader community of intensive care clinicians provided them with enhanced access to credible best practice knowledge. This evaluation of ICUConnect demonstrated that members belong to a virtual CoP with a diverse professional network to support their professional development and enable access to innovations in practice. It is recommended that healthcare organisations consider using virtual CoP to improve internal clinical practices. Further research is required to demonstrate if patient care and outcomes are improved by HCP participation in virtual CoPs.
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