THERE IS NO “I” IN TEAM: IMPACTS OF SURGICAL TEAM DYNAMICS ON OPERATIONAL PERFORMANCE AND CLINICAL OUTCOMES

While the complexities and challenges facing healthcare continue to grow, the focus on improving surgical practices remains constant. Possessing a strong influence over patient referral patterns, public reputation/prominence, and financial performance, surgical practices command heightened attention on operational performance and clinical outcomes. Executive leadership cannot support (nor improve) a surgical practice without comprehending the importance of team dynamics in the operating room (OR) environment.
Previous literature offers mixed and incomplete results on themes of team familiarity and OR efficiency, frequently citing handoffs, late starts, and task disruptions as catalysts for negative performance. Studies routinely use historical interaction counts to measure team familiarity, which often neglect the degree of participation (engagement) across prior experiences. Similarly, counts of handoffs or individuals entering an OR do not offer an accurate assessment of team performance. Guided by historical studies, four hypotheses are presented and argue that enhancing surgical team dynamics yield favorable improvements for operational performance and clinical outcomes. Utilizing data from 9,049 neurologic surgery cases performed at two separate campuses (belonging to the same organization) over a three-year timeframe (March 2019 to November 2021), this study measures surgical team dynamics in a highly complex setting through the lens of case continuity and surgeon familiarity to assess key outputs: case scheduling errors (proxy for operational performance) and post-operative complications within 30-days of surgery (proxy for clinical outcomes).