Operating room organization and surgical performance: a systematic review.

Area of Science:

• Healthcare Management
• Surgical Outcomes Research
• Organizational Psychology

Background:

• Organizational factors can affect surgical outcomes, independent of patient risk and surgical complexity.
• Existing literature extensively studies patient and surgical factors, but less on operating room organization.
• This study addresses the gap in understanding how operating room organization influences surgical performance.

Purpose of the Study:

• To explore how operating room organization determines surgical performance.
• To identify gaps in the literature regarding organizational factors in surgery.
• To provide evidence for prioritizing research in surgical environment optimization.

Main Methods:

• Systematic review of studies from Pubmed and Scopus (2000-2019) following PRISMA guidelines.
• Included studies evaluated associations between team composition, stability, teamwork, scheduling, and disturbing elements with operative time, patient safety, and costs.
• Methodology assessed using criteria like multicentric investigation and study design.

Main Results:

• 76 studies met inclusion criteria, focusing on team composition (44.7%), stability (19.7%), teamwork (14.5%), scheduling (11.8%), and disturbing elements (9.2%).
• Specialized, stable teams in dedicated operating rooms improved outcomes.
• Optimized teamwork reduced operative time; poor teamwork increased morbidity and costs. Disturbances and communication failures negatively impacted operative time and safety.

Conclusions:

• Limited evidence indicates operating room staffing and environment significantly influence patient outcomes.
• Further research on organizational drivers is essential for enhancing surgical performance.
• Prioritizing research in this area can lead to improved patient care and efficiency.