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

Abstract

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.

Learning Curves in Open, Laparoscopic, and Robotic Pancreatic Surgery

“…47 Beside surgeon related factors, the institutional learning curve should not be underestimated when looking at potential biases. 48,49 The institutional competency depends on the frequency of a specific surgery, team familiarity, 50 and training of surgical assistants, operating room nurses, and technical staff. 51,52 The relationship between hospital and surgeon volume, team familiarity, and decreased operative times up to improved postoperative outcomes has been shown repeatedly.…”

Impact of Unplanned Intra‐Operative Conversions on Outcomes in Minimally Invasive Pancreatoduodenectomy

“…Additionally, there exists a significant correlation between study sample sizes and number of procedures needed to surpass the learning curve, questioning the meaningfulness and applicability of these results [ 43 ]. It is paramount that future studies investigating the subject take into account not only surgeon (previous surgical [ 44 ] and simulation [ 45 ] experience, procedure-specific training and clinical fellowships [ 46 ]) and patient (BMI [ 47 ], comorbidities and tumour factors [ 10 ]) characteristics, but institutional expertise as well, which includes annual procedural volumes and team familiarity [ 48 ].…”

Familiarity: A Concept Analysis on Rural Life

“…Over-familiarity between two individuals may lead one individual to believe they know the other well enough to speak for them (Mapson & Major, 2021). Team research findings suggest familiarity improves team function, but over-familiarity may have a detrimental effect and impair team performance (Parker et al, 2020;Sieweke & Zhao, 2015). Additionally, the individual may see what they want to see without seeing what actually is (Harms et al, 2021).…”