Investigating Teamwork in the Operating Room

Abstract

patients, followed closely by privately insured patients, but long-term post-ORYGB resolution did not vary further by insurance. Obesity hypoventilation syndrome varied only to 6 months and nearly disappeared in Medicaid, private, and self-pay patients but persisted at nearly 50% of preoperative rates in Medicare. Cholelithiasis increased in Medicaid and Medicare patients but did not change postoperatively in private and self-pay patients. Abdominal hernia resulted most frequently in Medicaid patients through 24 months at rates nearly double the other 3 groups. Abdominal panniculitis increased in self-pay patients to levels more than double the other groups by 24 months. Gastroesophigal reflux disease decreased in all insurance groups but remained higher in Medicaid and Medicare patients vs privately insured patients through 24 months. The significance of increased self-pay alcohol consumption at 24 months is not clear from the data.Private and self-pay patients benefited more from ORYGB than did Medicaid or Medicare patients. Postoperatively, privately insured patients had the lowest rates of 5 weightrelated comorbidities and highest in none. Self-pay patients were highest in 3 comorbidities but resolved 24 others to the lowest levels. Medicaid and Medicare patients were highest in 16 and 11 comorbidities, respectively. Medicare patients were lowest in abdominal hernia. Medicaid patients were lowest in none.Conclusions | Our review of the literature reveals that these variations in outcomes following ORYGB have, to our knowledge, not been reported previously [4][5][6] and are important findings of this study. This advance knowledge can forewarn surgeons of possible results and post-ORYGB problems that may facilitate optimal treatment of these fragile patients.

Barriers and enablers to effective interprofessional teamwork in the operating room: A qualitative study using the Theoretical Domains Framework

“…It may be that while OR clinicians agree on the concept of "teamwork", the concept of "team" may be different. As Frasier and colleagues found, different OR professions offer a different definition of who they considered to be on their "team" for a given operation [43]. For example, nurses considered other nurses and technologists to be on their team and anaesthesiologists considers anyone involved in the provision of anaesthetic care to be on their team [43].…”

“…As Frasier and colleagues found, different OR professions offer a different definition of who they considered to be on their "team" for a given operation [43]. For example, nurses considered other nurses and technologists to be on their team and anaesthesiologists considers anyone involved in the provision of anaesthetic care to be on their team [43]. Consequently, a key challenge with OR teamwork may be its conceptualization as profession-specific rather than truly interprofessional.…”

An Explorative Study Into Situational Artefact Construction in Business Rules Management

“…Careful preparation and planning is needed to identify the team members and to identify steps for implementation. Integration in (ICT) systems and regular activities by updating protocols is needed during the implementation (Frasier et al, 2017;Meyfroidt, 2009).…”

“…Operating Rooms (OR's) are one of the most complex, high tech and high reliability environments to implement radical transformations. In OR´s surgeries are performed by surgeons, supported by anesthetic (supportive) staff and surgical supporting staff (scrub and circulating nurses) (Frasier et al, 2017;Kang, Massey, & Gillespie, 2015;Sheikhzadeh, Gore, Zuckerman, & Nordin, 2009). To enable these surgeries additional stakeholders are involved, such as the sterilization department, logistical employees and in some instances operators, or manufacturers of medical equipment.…”

“…ST BLED ECONFERENCE: DIGITAL TRANSFORMATION: MEETING THE CHALLENGES JUNE 17 -20, 2018, BLED, SLOVENIA, CONFERENCE PROCEEDINGS N. S. Misser, J. Jaspers, B. van Zaane, H. Gooszen & J. Versendaal: Transforming operating rooms: factors for successful implementations of new medical equipment(Bhatt, Carlson, & Deckers, 2014;Frasier et al, 2017;Marvik, Lango, & Yavuz, 2004;Pennington & DeRienzo, 2010;Saleem et al, 2015).…”