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Assessing the performance of surgical teams
Linda Searle Leach1, Robert C Myrtle, Fred A Weaver
1University of California Los Angeles, School of Nursing, Los Angeles, CA, USA. lleach@sonnet.ucla.edu
Health Care Management Review
|December 24, 2008
Summary
Surgical teams face challenges with coordination and frequent hand-offs, impacting performance. Effective leadership and relational coordination are key to improving surgical outcomes and reducing errors in complex operating room environments.
Area of Science:
- Healthcare Team Dynamics
- Surgical Process Optimization
- Patient Safety in Acute Care
Background:
- High-performing teams are crucial for service delivery, especially in acute care hospitals.
- Understanding surgical team dynamics and performance is essential for high-quality surgical care.
- Challenges to operating room team functioning, working conditions, and environmental context require further investigation.
Purpose of the Study:
- To describe the nature of surgical teams and their performance within the operating room.
- To contribute to the understanding of high-performing and high-reliability teams in healthcare.
- To identify factors influencing surgical team effectiveness.
Main Methods:
- Qualitative study using direct observation and semistructured interviews.
- Observation of 10 high-complexity surgeries and interviews with 26 surgical team members.
- Analysis of transcribed data guided by a conceptual framework to identify performance influencers.
Main Results:
- Coordination types and interdependence varied across surgical stages.
- Ad hoc surgical teams experienced frequent hand-offs for breaks, challenging team continuity.
- Role demands and situational dynamics impacted the team's adaptive capacity.
Conclusions:
- Surgical events require dynamic coordination and adaptation to complexity and uncertainty.
- Relational coordination, facilitated by leadership, enhances surgical outcomes and reduces errors.
- Effective team functioning in surgery promotes knowledge creation and dissemination, particularly in teaching hospitals.
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