The Impact of Surgical Team Familiarity on Length of Procedure and Length of Stay: Inconsistent Relationships Across Pro
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ORIGINAL SCIENTIFIC REPORT
The Impact of Surgical Team Familiarity on Length of Procedure and Length of Stay: Inconsistent Relationships Across Procedures, Team Members, and Sites Sarah Henrickson Parker1,2 • Xue Lei3 • Shimae Fitzgibbons4 • Thomas Metzger5 Shawn Safford6 • Seth Kaplan3
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Ó Socie´te´ Internationale de Chirurgie 2020
Abstract Background Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying the relative importance of familiarity among all possible core team dyads, and defining the impact of team level familiarity on outcomes. Materials and methods Using a retrospective chart and administrative data review, five years of data from two health systems (14 hospitals) and across two procedures, (knee arthroplasty and lumbar laminectomy) were included. Multilevel modeling approach and a dominance analysis were conducted. Results For each previous surgery that any two members of the core surgical team had participated in together, the length of surgery decreased significantly. The familiarity of the scrub and the surgeon was the most significant relationship for knee arthroplasty across the two hospitals, and laminectomies at one hospital. Conclusions The relationship between familiarity of the surgical team and surgical efficiency may be more complex than previously articulated. Familiarity may be more important for certain types of procedures. The familiarity of certain dyads may be more important for certain types of procedures.
Introduction & Sarah Henrickson Parker [email protected] 1
Department of Biomedical Science, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, VA, USA
2
Department of Psychology, Fralin Biomedical Research Institute, Virginia Tech, 2 Riverside Cir, Roanoke, VA 24014, USA
3
Department of Psychology, George Mason University, Fairfax, VA, USA
4
Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA
5
Department of Statistics, Virginia Tech, Blacksburg, VA, USA
6
Department of Pediatric Surgery, Carilion Clinic, Roanoke, VA, USA
Efforts within surgery to improve teamwork—and, in turn, patient safety—have largely focused on specific behavioral strategies, such as the use of checklists, briefings [1, 2], and teamwork training. There is increasing recognition that the particular individuals who happen to compose the team for a given procedure come with their own personalities, tendencies, and experiences. Considerable evidence from fields such as organizational behavior and psychology reveals that the specific mix of people on the team can be an important determinant of team processes and outcomes [3–5]. Within this broader literature on team composition, studies have identified prior familiarity among team members as a predictor of team effectiveness [6–8]. However,
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