Surgical time independently affected by surgical team size
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Maria A Cassera1, Bin Zheng, Danny V Martinec
1Minimally Invasive Surgery Program, Legacy Health System, 1040 NW 22nd Ave., Suite 560, Portland, OR 97210, USA.
Background:
Team size and composition provide essential data for the study of operating room (OR) efficiency.
Methods:
Laparoscopic procedures between July 2005 and July 2007 were reviewed retrospectively to record the number of OR personnel and the procedure time (PT).
Results:
Of 399 procedures reviewed, 360 cases with complete data were analyzed. The average PT was 148 minutes. A mean of 8 different team members (range, 4-15) were involved. Surgeons and anesthesiologists stayed constant whereas the OR nurses were replaced more than once per procedure (mean, 4 nurses/procedure; range, 2-11). Multiple regression analysis revealed that both complexity of surgery and team size affected the PT significantly. When procedure complexity and patient condition were held constant, we found that adding 1 individual to a team predicted a 15.4-minutes increase in PT.
Conclusions:
The surgical team is a dynamic system with a large amount of member turnover. Efforts to improve OR efficiency should focus on decreasing surgical team size, limiting staff turnover, and enhancing communication between team members.
Insights
Larger surgical teams and frequent staff changes increase operating room (OR) procedure times. Optimizing OR efficiency requires smaller, stable teams and better communication.
Area of Science:
- Surgical Sciences
- Healthcare Management
- Operating Room Efficiency
Background:
- Operating room (OR) efficiency is significantly influenced by team size and composition.
- Understanding these dynamics is crucial for optimizing surgical workflows.
Purpose of the Study:
- To investigate the relationship between surgical team size, composition, and procedure time (PT).
- To identify factors affecting OR efficiency in laparoscopic procedures.
Main Methods:
- Retrospective review of 399 laparoscopic procedures (July 2005-July 2007).
- Data collected included OR personnel numbers and procedure time (PT).
- Multiple regression analysis used to assess the impact of team size and surgical complexity on PT.
Main Results:
- 360 cases with complete data were analyzed; average PT was 148 minutes.
- Mean team size was 8 members (range, 4-15), with significant OR nurse turnover.
- Increased team size (by 1 member) correlated with a 15.4-minute increase in PT, holding other factors constant.
Conclusions:
- Surgical teams are dynamic systems with high member turnover.
- Improving OR efficiency necessitates reducing team size and staff turnover.
- Enhancing inter-team communication is vital for optimizing surgical workflows.
