FEATURE ARTICLEUsing *ORA, a Network Analysis Tool, to Assess the Relationship of Handoffs to Quality and Safety OutcomesEFFKEN, JUDITH A. PhD, RN; GEPHART, SHEILA M. PhD, RN; BREWER, BARBARA B. PhD, RN, MALS, MBA; CARLEY, KATHLEEN M. PhDAuthor Information Author Affiliations: The University of Arizona (Drs Effken, Gephart, and Brewer), Tucson, AZ; and Carnegie Mellon University (Dr Carley), Pittsburgh, PA. The work described in this article was supported by a grant from the National Library of Medicine (NIH) (1R01LM009516-01A1) (Drs Effken, Carley, and Brewer, principal investigators). All authors received funding from this source through their respective universities. However, the funding agency had no part in the writing of this article. Dr Carley originally developed *ORA through the CASOS center at Carnegie Mellon. It is now being further developed and distributed through Netanomics, a small business of which she is the CEO. The CASOS group received various grants and contracts for the general development of *ORA, which is freely available on the CASOS Web site. Portions of this article were presented at the Institute on Systems Science and Health in New York City on June 14, 2010. Corresponding author: Judith A. Effken, PhD, RN, College of Nursing,The University of Arizona, PO Box 210213, Tucson, AZ 85721 (email@example.com). Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.cinjournal.com). CIN: Computers, Informatics, Nursing: January 2013 - Volume 31 - Issue 1 - p 36-44 doi: 10.1097/NXN.0b013e3182701082 Buy Metrics Abstract Communication during patient handoffs has been widely implicated in patient safety issues. However, few studies have actually been able to quantify the relationship between handoffs and patient outcomes. We used *ORA, a dynamic network analysis tool, to examine handoffs between day and night shifts on seven units in three hospitals in the Southwest. Using *ORA’s visualization and analysis capabilities, we examined the relationships between the handoff communication network metrics and a variety of patient safety quality and satisfaction outcomes. Unique network patterns were observed for different types of outcome variable (eg, safety, symptom management, self-care, and patient satisfaction). This exploratory project demonstrates the power of *ORA to identify communication patterns for large groups, such as patient care units. *ORA’s network metrics can then be related to specific patient outcomes. © 2013 Lippincott Williams & Wilkins, Inc.