Do teams of strangers create health care dangers? The effect of OR team consistency on operative times in adolescent idiopathic scoliosis.

Autor: Givens RR; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA. rrg2158@cumc.columbia.edu., Brown M; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA., Malka MS; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA., Lu K; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA., Zervos TM; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA., Roye BD; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA., Pinyavat T; Division of Pediatric Anesthesiology, Department of Anesthesiology, Columbia University Irving Medical Center, New York, NY, USA., Flynn JM; Division of Orthopaedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.; The University of Pennsylvania School of Medicine, Philadelphia, PA, USA., Vitale MG; Division of Pediatric Orthopedic Surgery, Department of Orthopedic Surgery, Columbia University Irving Medical Center, New York, NY, USA.
Jazyk: angličtina
Zdroj: Spine deformity [Spine Deform] 2024 Sep 25. Date of Electronic Publication: 2024 Sep 25.
DOI: 10.1007/s43390-024-00964-2
Abstrakt: Purpose: Teamwork and communication are important components of any surgical team. This study uses a simple, reproducible, and quantitative "team consistency score" and a nodal-based model for examining prior interactions amongst team members to represent and quantify the regularity of an OR team for a specific surgical case.
Methods: The electronic medical record (EMR) at our institution was queried for pediatric patients undergoing spinal surgery from January 2021 through December 2023. The number of prior interactions between individuals filling distinct roles in the OR for each case was recorded. A metric coined the consistency score was developed representing the sum total of these prior interactions standardized to a reference case. Spearman's Correlation as well as the Mann-Whitney comparison test were used to analyze the associations between case team consistency score and efficiency measures.
Results: 154 cases were included for analysis. There was a statistically significant negative correlation between case consistency score and both anesthesia time (rho = -0.159; p < 0.05) and patient preparation time (rho = -0.218; p < 0.01). When looking at the consistent (above median consistency score of 0.46) vs. inconsistent cohorts, the inconsistent cohort had a higher mean patient preparation time (53.3 ± 14.0 min vs. 49.0 ± 9.3 min; p < 0.05), as well as a higher overall mean case length (336.6 ± 47.4 min vs. 321.9 ± 42.4 min; p < 0.05).
Conclusion: The findings suggest that increased team consistency, as measured by a "team consistency score" metric, is related to heightened efficiency and reduced intraoperative times.
(© 2024. The Author(s), under exclusive licence to Scoliosis Research Society.)
Databáze: MEDLINE
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