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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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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.

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Acknowledgements

A special thanks to Ronex Muthukattil for facilitating data extraction, Sandra Keller for thoughtful edits on multiple versions of this manuscript, and Carolyn Winslow for her early support of the project.

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Authors and Affiliations

  1. Department of Biomedical Science, Virginia Tech Carilion School of Medicine and Research Institute, Roanoke, VA, USA

    Sarah Henrickson Parker

  2. Department of Psychology, Fralin Biomedical Research Institute, Virginia Tech, 2 Riverside Cir, Roanoke, VA, 24014, USA

    Sarah Henrickson Parker

  3. Department of Psychology, George Mason University, Fairfax, VA, USA

    Xue Lei & Seth Kaplan

  4. Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA

    Shimae Fitzgibbons

  5. Department of Statistics, Virginia Tech, Blacksburg, VA, USA

    Thomas Metzger

  6. Department of Pediatric Surgery, Carilion Clinic, Roanoke, VA, USA

    Shawn Safford

Authors
  1. Sarah Henrickson Parker
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  2. Xue Lei
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  3. Shimae Fitzgibbons
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  4. Thomas Metzger
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  5. Shawn Safford
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  6. Seth Kaplan
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Contributions

SHP conceived the study, collected the data, contributed the data, wrote and made substantial edits to the paper. XL performed the analysis, wrote and made substantial edits to the paper. SF collected the data, contributed the data, made substantial edits to the paper, provided subject matter expertise. TM performed the analysis and contributed analysis tools, made substantial edits to the paper. SS contributed data analysis tools, made substantial edits to the paper, provided subject matter expertise. SK conceived the study, performed the analysis, wrote and made substantial edits to the paper, provided subject matter expertise.

Corresponding author

Correspondence to Sarah Henrickson Parker.

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Conflict of interest

This work was supported by a grant from the Carilion Clinic Research Acceleration Program (Henrickson Parker PI) and the MedStar Scholars program (Fitzgibbons PI). There are no other relevant disclosures for any authors. There are no conflicts of interest in this manuscript for any of the authors. This study was approved by the Carilion Clinic IRB (2023).

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Parker, S.H., Lei, X., Fitzgibbons, S. et al. The Impact of Surgical Team Familiarity on Length of Procedure and Length of Stay: Inconsistent Relationships Across Procedures, Team Members, and Sites. World J Surg 44, 3658–3667 (2020). https://doi.org/10.1007/s00268-020-05657-1

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  • DOI: https://doi.org/10.1007/s00268-020-05657-1

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