A novel team Familiarity Score for operating teams is a predictor of length of a procedure: A retrospective Bayesian analysis

Powezka, Katarzyna; Normahani, Pasha; Standfield, Nigel; Jaffer, Usman

doi:10.1016/j.jvs.2019.03.085

Cited by 10 publications

(8 citation statements)

References 27 publications

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“…Higher familiarity was associated with reduced operating duration, postoperative length of stay, and severity of postoperative complications. 62 That study relied on single-center data and its usefulness in work organization and policy is limited by the complexity of the score. The current study provides novel information regarding the potential role of the surgeon-anesthesiologist dyad familiarity in patient outcomes within a large sample of complex gastrointestinal cancer surgery using population-based data across an entire health care system.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, an operating room familiarity score was developed for vascular surgery, whereby the sum of the number of times that each pair of team members (surgeons, anesthesiologists, nurses, anesthesia assistants, and trainees) worked together over 6 months was used in a complex equation. Higher familiarity was associated with reduced operating duration, postoperative length of stay, and severity of postoperative complications . That study relied on single-center data and its usefulness in work organization and policy is limited by the complexity of the score.…”

Section: Discussionmentioning

confidence: 99%

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Association Between Familiarity of the Surgeon-Anesthesiologist Dyad and Postoperative Patient Outcomes for Complex Gastrointestinal Cancer Surgery

et al. 2023

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ImportanceThe surgeon-anesthesiologist teamwork and relationship is crucial to good patient outcomes. Familiarity among work team members is associated with enhanced success in multiple fields but rarely studied in the operating room.ObjectiveTo examine the association between surgeon-anesthesiologist dyad familiarity—as the number of times working together—with short-term postoperative outcomes for complex gastrointestinal cancer surgery.Design, Setting, and ParticipantsThis population-based retrospective cohort study based in Ontario, Canada, included adults undergoing esophagectomy, pancreatectomy, and hepatectomy for cancer from 2007 through 2018. The data were analyzed January 1, 2007, through December 21, 2018.ExposuresDyad familiarity captured as the annual volume of procedures of interest done by the surgeon-anesthesiologist dyad in the 4 years before the index surgery.Main Outcomes and MeasuresNinety-day major morbidity (any Clavien-Dindo grade 3 to 5). The association between exposure and outcome was examined using multivariable logistic regression.ResultsSeven thousand eight hundred ninety-three patients with a median age of 65 years (66.3% men) were included. They were cared for by 737 anesthesiologists and 163 surgeons who were also included. The median surgeon-anesthesiologist dyad volume was 1 (range, 0-12.2) procedures per year. Ninety-day major morbidity occurred in 43.0% of patients. There was a linear association between dyad volume and 90-day major morbidity. After adjustment, the annual dyad volume was independently associated with lower odds of 90-day major morbidity, with an odds ratio of 0.95 (95% CI, 0.92-0.98; P = .01) for each incremental procedure per year, per dyad. The results did not change when examining 30-day major morbidity.Conclusions and RelevanceAmong adults undergoing complex gastrointestinal cancer surgery, increasing familiarity of the surgeon-anesthesiologist dyad was associated with improved short-term patient outcomes. For each additional time that a unique surgeon-anesthesiologist dyad worked together, the odds of 90-day major morbidity decreased by 5%. These findings support organizing perioperative care to increase the familiarity of surgeon-anesthesiologist dyads.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association Between Familiarity of the Surgeon-Anesthesiologist Dyad and Postoperative Patient Outcomes for Complex Gastrointestinal Cancer Surgery

et al. 2023

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“…(stable: 15.2%; p = 0.03; dynamic 8.7% p = 0.19). A study of Powezka et al [16] performed a retrospective analysis of 326 vascular procedures. They introduced the Familiarity Score, which yields the total of numbers of times each team member (vascular consultant, vascular registrar, scrub nurse, anesthetic consultant) had worked together, in the previous six months, divided by the number of possible combinations of pairs in the team.…”

Section: Discussionmentioning

confidence: 99%

Variation of in-hospital trauma team staffing: new resuscitation, new team

et al. 2022

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Background Non-technical errors, such as insufficient communication or leadership, are a major cause of medical failures during trauma resuscitation. Research on staffing variation among trauma teams on teamwork is still in their infancy. In this study, the extent of variation in trauma team staffing was assessed. Our hypothesis was that there would be a high variation in trauma team staffing. Methods Trauma team composition of consecutive resuscitations of injured patients were evaluated using videos. All trauma team members that where part of a trauma team during a trauma resuscitation were identified and classified during a one-week period. Other outcomes were number of unique team members, number of new team members following the previous resuscitation and new team members following the previous resuscitation in the same shift (Day, Evening, Night). Results All thirty-two analyzed resuscitations had a unique trauma team composition and 101 unique members were involved. A mean of 5.71 (SD 2.57) new members in teams of consecutive trauma resuscitations was found, which was two-third of the trauma team. Mean team members present during trauma resuscitation was 8.38 (SD 1.43). Most variation in staffing was among nurses (32 unique members), radiology technicians (22 unique members) and anesthetists (19 unique members). The least variation was among trauma surgeons (3 unique members) and ER physicians (3 unique members). Conclusion We found an extremely high variation in trauma team staffing during thirty-two consecutive resuscitations at our level one trauma center which is incorporated in an academic teaching hospital. Further research is required to explore and prevent potential negative effects of staffing variation in trauma teams on teamwork, processes and patient related outcomes.

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“…We made this choice initially due to the complexity of the study variables. Previous work has also used 6‐months as a meaningful break point [12, 28]. However, the recency of the last interaction may impact team interactions, which calls for further research.…”

Section: Discussionmentioning

confidence: 99%

The Impact of Surgical Team Familiarity on Length of Procedure and Length of Stay: Inconsistent Relationships Across Procedures, Team Members, and Sites

et al. 2020

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Background Team familiarity has been shown to be important for operative efficiency and number of complications, but it is unclear for which types of operations and for which team members familiarity matters the most. The objective of this study is to further our understanding of familiarity in the OR by quantifying the relative importance of familiarity among all possible core team dyads, and defining the impact of team level familiarity on outcomes. Materials and methods Using a retrospective chart and administrative data review, five years of data from two health systems (14 hospitals) and across two procedures, (knee arthroplasty and lumbar laminectomy) were included. Multilevel modeling approach and a dominance analysis were conducted. Results For each previous surgery that any two members of the core surgical team had participated in together, the length of surgery decreased significantly. The familiarity of the scrub and the surgeon was the most significant relationship for knee arthroplasty across the two hospitals, and laminectomies at one hospital. Conclusions The relationship between familiarity of the surgical team and surgical efficiency may be more complex than previously articulated. Familiarity may be more important for certain types of procedures. The familiarity of certain dyads may be more important for certain types of procedures.

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A novel team Familiarity Score for operating teams is a predictor of length of a procedure: A retrospective Bayesian analysis

Cited by 10 publications

References 27 publications

Association Between Familiarity of the Surgeon-Anesthesiologist Dyad and Postoperative Patient Outcomes for Complex Gastrointestinal Cancer Surgery

Association Between Familiarity of the Surgeon-Anesthesiologist Dyad and Postoperative Patient Outcomes for Complex Gastrointestinal Cancer Surgery

Variation of in-hospital trauma team staffing: new resuscitation, new team

The Impact of Surgical Team Familiarity on Length of Procedure and Length of Stay: Inconsistent Relationships Across Procedures, Team Members, and Sites

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