When most people hear the words "social network," they think of the recent movie or one of the many websites that "bring people together." But the General Surgery unit at TGH has put a twist on social networking, proving that it's useful for more than just keeping track of friends in far-off places. Led by Nurse Manager Brenda Perkins-Meingast, the unit has been busy working on a new hand hygiene initiative with the Infection Prevention and Control (IPAC) department that maps the relationships between the people on her team.

Each staff member in General Surgery was sent a questionnaire (which also went to key players like Dr. Bob Bell, CEO and President, UHN, and IP​​AC) that probed their relationships with one another. The survey asked things like who staff members interact with most frequently, who they want to work with in the future, and what their interests are in fighting hospital-acquired infections. The answers were then run through a specialized software program which created a series of social network maps for each question, showing where people overlap or how closely they connect to one another. Think of it as six degrees of separation, the hospital edition.​

The initiative is also part of a UHN-wide effort to boost awareness of hand hygiene and lower rates of hospital-acquired infections called Positive Deviance. Positive Deviance is based on the idea that in every community there are certain individuals or groups who, with the same resources and tools as their peers, combine them with uncommon, successful behaviors or strategies to create better solutions to a problem.​

"I tried social network mapping because it's new, innovative and cool, but also because I believe in relationships," says Perkins-Meingast. "And when you look at complex systems, it's fascinating to see how people connect, where they go for inspiration and information, and who they'd like to work with in the future."

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Answers to "Who do you talk to today?" mapped out. Each node represents a different person (names removed), showing relationship between people and job positions.​

The resulting maps clearly illustrate the links between people in a selected group. When a question like "Who would you talk to about the prevention of superbugs today?" is answered by every member of a unit, certain people—dubbed "change champions"—become obvious just by looking at a diagram.​

Conversely, social network maps show those on the periphery as clearly as those smack dab in the middle. While Perkins-Meingast plans on reaching out to those individuals further from the centre, she is quick to point out that, "the buy-in can't be forced; Positive Deviance is about working with those that are committed and want to see a change."


"We've changed the story… we want to say that 'it's not acceptable for someone to come into the hospital and get sick as a result of us,'" says Perkins-Meingast. "We'r​e not there yet, but I think if you stay true to the story this vision will take form. Things like Dr. Bryce Taylor taking time out of his busy schedule to do hand hygiene audits on the floor is really important. It shows the value we place on changing behaviour."​​

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