Novel Application of a Dynamic, In-Room Survey Platform to Measure Surgical Team Satisfaction

Abstract

Objective: This study aims to elucidate the potential usage of continuous feedback regarding team satisfaction and correlations with operative performance and patient outcomes. Background: Continuous, actionable assessment of teamwork quality in the operating room (OR) is challenging. This work introduces a novel, data-driven approach to prospectively and dynamically assess healthcare provider (HCP) satisfaction with teamwork in the OR. Methods: Satisfaction with teamwork quality for each case was assessed utilizing a validated prompt displayed on HappyOrNot® Terminals™ placed in all ORs, with separate panels for circulators, scrub nurses, surgeons, and anesthesia providers. Responses were cross-referenced with OR log data, team familiarity indicators, efficiency parameters and patient safety indicator events through continuous, semi-automated data marts. De-identified responses were analyzed via logistic regression modeling. Results: Over a 24-week period, 4,123 responses from 2,107 cases were recorded. The overall response rate per-case was 32.5%. Greater scrub nurse specialty experience was strongly associated with satisfaction (odds ratio 2.15, 95% CI 1.53—3.03, P<0.001). Worse satisfaction was associated with longer than expected procedure time (odds ratio 0.91, 95% CI 0.82—1.00, P=0.047), nighttime (0.67, 95% CI 0.55—0.82, P<0.001) and add-on cases (0.72, 95% CI 0.60—0.86, P<0.001). Higher material costs (22%, 95% CI 6—37%, P=0.006) were associated with greater team satisfaction. Cases with superior teamwork ratings were associated with a 15% shorter length of hospital stay (95% CI 4—25%, P=0.006). Conclusions: This study demonstrates for the feasibility of a dynamic survey platform to report actionable HCP satisfaction metrics in real-time. Team satisfaction is associated with modifiable team variables and some key operational outcomes. Leveraging qualitative measurements of teamwork as operational indicators may augment staff engagement and measures of performance.