Department of Surgery, University of Chicago Medicine, Chicago, IL.
Booth School of Business, University of Chicago, Chicago, IL.
Ann Surg. 2023 May 1;277(5):e1006-e1017. doi: 10.1097/SLA.0000000000005463. Epub 2022 Jul 6.
To propose a framework for quantification of surgical team familiarity.
Operating room (OR) teamwork quality is associated with familiarity among team members and their individual specialization. We describe novel measures of OR team familiarity and specialty experience.
Surgeon-scrub (SS) and surgeon-circulator (SC) teaming scores, defined as the pair's proportion of interactions relative to the surgeon's total cases in the preceding 6 months were calculated between 2017 and 2021 at an academic medical center. Nurse service-line (SL) experience scores were defined as the proportion of a nurse's cases performed within the given specialty. SS, SC, and nurse-SL scores were analyzed by specialty, case urgency, robotic approach, and surgeon academic rank. Two-sample Kolmogorov-Smirnov tests were used to determine heterogeneity between distributions.
A total of 37,364 operations involving 150 attending surgeons and 222 nurses were analyzed. Median SS and SC scores were 0.08 (interquartile range: 0.03-0.19) and 0.06 (interquartile range: 0.03-0.13), respectively. Higher margin SLs, senior faculty rank, elective, and robotic cases were associated with greater SS, SC, and nurse-SL scores ( P <0.001).
These novel measures of teaming and specialization illustrate the low levels of OR team familiarity and objectively highlight differences that necessitate a deliberate evaluation of current OR scheduling practices.
提出一种量化手术团队熟悉度的框架。
手术室（OR）团队协作质量与团队成员之间的熟悉程度及其个人专业化程度相关。我们描述了 OR 团队熟悉度和专业经验的新度量方法。
2017 年至 2021 年，在一家学术医疗中心计算了外科医生-洗手护士（SS）和外科医生巡回护士（SC）团队得分，定义为在过去 6 个月中，每对团队成员的互动比例与外科医生的总手术例数之比。护士服务线（SL）经验得分定义为护士在特定专业中完成的病例比例。根据专业、病例紧急程度、机器人手术方式和外科医生的学术级别分析 SS、SC 和护士-SL 得分。使用双样本 Kolmogorov-Smirnov 检验来确定分布之间的异质性。
共分析了 37364 例手术，涉及 150 名主治外科医生和 222 名护士。SS 和 SC 的中位数分别为 0.08（四分位距：0.03-0.19）和 0.06（四分位距：0.03-0.13）。较高的 SL、高级教员职称、择期和机器人手术与更高的 SS、SC 和护士-SL 得分相关（P<0.001）。
这些新的团队协作和专业化度量方法说明了手术室团队熟悉度水平较低，并客观地突出了需要对当前手术室排班实践进行评估的差异。
