Department of Surgery (Division of Vascular Surgery), University Medical Center Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands.
Department of Cardiothoracic Surgery, Leiden University Medical Center, Albinusdreef 2, Leiden 2333 ZA, The Netherlands.
Int J Qual Health Care. 2022 Oct 27;34(4). doi: 10.1093/intqhc/mzac078.
A dedicated operating team is defined as a surgical team consisting of the same group of people working together over time, optimally attuned in both technical and/or communicative aspects. This can be achieved through technical and/or communicative training in a team setting. A dedicated surgical team may contribute to the optimization of healthcare quality and patient safety within the perioperative period.
A systematic review was conducted to evaluate the effects of a dedicated surgical team on clinical and performance outcomes. MEDLINE and Embase were searched on 23 June 2022. Both randomized controlled trials (RCTs) and non-randomized studies (NRSs) were included. Primary outcomes were mortality, complications and readmissions. Secondary outcomes were costs and performance measures.
Fourteen studies were included (RCTs n = 1; NRSs n = 13). Implementation of dedicated operating teams was associated with improvements in mortality, turnover time, teamwork, communication and costs. No significant differences were observed in readmission rates and length of hospital stay. Results regarding duration, glitch counts and complications of surgery were inconclusive. Limitations include study conduct and heterogeneity between studies.
The institution of surgical teams who followed communicative and/or technical training appeared to have beneficial effects on several clinical outcome measures. Dedicated teams provide a feasible way of improving healthcare quality and patient safety. A dose-response effect of team training was reported, but also a relapse rate, suggesting that repetitive training is of major concern to high-quality patient care. Further studies are needed to confirm these findings, due to limited level of evidence in current literature.
CRD42020145288.
专门的手术团队是指由同一组人员组成、长期合作的手术团队，他们在技术和/或沟通方面都非常默契。这可以通过团队环境中的技术和/或沟通培训来实现。专门的手术团队可以有助于优化围手术期的医疗质量和患者安全。
系统检索了 2022 年 6 月 23 日的 MEDLINE 和 Embase 数据库，以评估专门的手术团队对临床和绩效结果的影响。纳入了随机对照试验（RCT）和非随机研究（NRS）。主要结局是死亡率、并发症和再入院率。次要结局是成本和绩效指标。
共纳入了 14 项研究（RCT 研究 n=1；NRS 研究 n=13）。专门手术团队的实施与死亡率、周转时间、团队合作、沟通和成本的改善相关。再入院率和住院时间无显著差异。手术时间、故障次数和并发症的结果尚无定论。研究的局限性包括研究设计和研究之间的异质性。
实施遵循沟通和/或技术培训的手术团队似乎对多个临床结局指标有有益的影响。专门的团队为提高医疗质量和患者安全提供了可行的方法。报告了团队培训的剂量反应效应，但也存在复发率，这表明重复培训对高质量的患者护理非常重要。由于现有文献的证据水平有限，需要进一步的研究来证实这些发现。
PROSPERO 注册号：CRD42020145288。
