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The teamwork structure, process, and context of a paediatric cardiac surgery team in Mongolia: A mixed-methods
Seungheon Han1,2, Sugy Choi2,3, Jayoung Park2
1Korea Institute of Public Administration, Seoul, South Korea.
Insights
Teamwork in paediatric cardiac surgery in Mongolia needs improvement. Enhancing communication and goal alignment is crucial for better surgical outcomes in low- and middle-income countries (LMICs).
Area of Science:
- Medicine
- Surgery
- Public Health
Background:
- Effective teamwork is vital for paediatric cardiac surgery outcomes.
- Teamwork in low- and middle-income countries (LMICs) remains understudied.
- Mongolia's paediatric cardiac surgical care requires strengthened team-based approaches.
Purpose of the Study:
- To examine multiple dimensions of teamwork in paediatric cardiac surgery in Mongolia.
- To inform the development of a team-based training program.
- To enhance paediatric cardiac surgical care in an LMIC setting.
Main Methods:
- A mixed-methods approach was employed.
- Social network analysis (n=24) explored team structure.
- In-depth interviews (n=9) investigated teamwork process, quality, and context.
Main Results:
- The team structure was dense and decentralized, with intensive care unit nurses showing high betweenness-centrality.
- Lack of regular joint decision-making hindered common goal formation.
- Explicit roles limited communication and responsibility-sharing, despite strong interpersonal relationships.
Conclusions:
- Well-structured, goal-oriented communication is essential for effective paediatric cardiac surgery teamwork in LMICs.
- Managing collaboration quality is key to improving team effectiveness.
- Findings highlight the need for targeted interventions in LMIC surgical teams.
Introduction:
Effective teamwork in paediatric cardiac surgery is known to improve team performance and surgical outcomes. However, teamwork in low- and middle-income countries (LMICs), including Mongolia, is understudied. We examined multiple dimensions of teamwork to inform a team-based training programme to strengthen paediatric cardiac surgical care in Mongolia.
Methods:
We used a mixed-methods approach, combining social network analysis and in-depth interviews with medical staff, to explore the structure, process, quality, and context of teamwork at a single medical centre. We conceptualised the team's structure based on communication frequency among the members (n = 24) and explored the process, quality, and context of teamwork via in-depth interviews with select medical staff (n = 9).
Results:
The team structure was highly dense and decentralised, but the intensive care unit nurses showed high betweenness-centrality. In the quality and process domain of teamwork, we did not find a regular joint decision-making process, leading to the absence of common goals among the team members. Although role assignment among the medical staff was explicit, those strictly defined roles hindered active communication about patient information and responsibility-sharing. Most interviewees did not agree with the organisational policies that limited discussions among team members; therefore, medical staff continued to share training and work experiences with each other, leading to strong and trustworthy relationships.
Conclusion:
The findings of this study underscore the importance of well-structured and goal-oriented communication between medical staff, as well as the management of the quality of collaboration within a team to increase teamwork effectiveness in paediatric cardiac surgery teams in LMICs.
