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Relationship Between Surgeon Nontechnical Skills and Operating Team Efficiency: A Mixed-Methods Study.

Egide Abahuje1, Lixuan Cong2, My Nguyen3

  • 1From the Department of Cardiac Surgery, University of Michigan, Ann Arbor, MI (Abahuje).

Journal of the American College of Surgeons
|October 22, 2025
PubMed
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This summary is machine-generated.

Surgeons with better non-technical skills, measured by the Non-Technical Skills for Surgeons (NOTSS) tool, significantly improve operating room efficiency. Enhanced skills correlate with on-time starts, optimal procedure length, and faster turnover.

Area of Science:

  • Surgical Performance Metrics
  • Operating Room Efficiency
  • Healthcare Management

Background:

  • Intraoperative non-technical skills are crucial for optimal patient care.
  • This study investigates the impact of surgeons' non-technical skills on operating team efficiency.

Purpose of the Study:

  • To assess the influence of surgeons' non-technical skills on operating room efficiency.
  • To quantify the relationship between Non-Technical Skills for Surgeons (NOTSS) scores and key OR performance indicators.

Main Methods:

  • Convergent parallel mixed methods study using non-participant observations.
  • Assessed surgeon non-technical skills using the Non-Technical Skills for Surgeons (NOTSS) tool.
  • Compared NOTSS scores with OR efficiency metrics: on-time start, procedure length, and turnover time.

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Main Results:

  • Higher NOTSS scores significantly correlated with increased proportion of on-time first case starts.
  • Improved NOTSS scores were associated with a higher proportion of actual to expected operation length.
  • Enhanced non-technical skills led to a greater proportion of case turnovers within the expected time.
  • Qualitative data revealed themes of preoperative planning, clear intraoperative cues, and effective debriefing/briefing.

Conclusions:

  • A positive association exists between surgeons' Non-Technical Skills for Surgeons (NOTSS) scores and surgical team efficiency.
  • Effective communication is vital for team situation awareness throughout surgical procedures.
  • Findings suggest potential for interventions to enhance OR efficiency by improving non-technical skills.