Military Surgical Team Performance: The Impact of Familiarity, Team Size, and Nurse Anesthesia Students

Stucky, Christopher H.; Jong, Marla J. De; Liu, Yuliang

doi:10.1016/j.jopan.2021.04.008

Cited by 11 publications

(3 citation statements)

References 41 publications

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“…Results of a study on team familiarity in a military medical center showed that the expected turnover time decreased when team familiarity increased; however, late starts and expected turnover times increased when a student nurse anesthetist who was unfamiliar with processes joined the team. 33 Effective interprofessional relationships can drive performance and improve outcomes. 34 Because surgical efficiency is a modifiable function of surgical teams, we suggest perioperative leaders engage in a continuous cycle of performance improvement that includes developing a multifaceted program to improve OR utilization.…”

Section: Discussionmentioning

confidence: 99%

“…Team familiarity , which is the ability of interdisciplinary team members to collaborate, communicate, and share the same mental model, 32 can affect OR utilization. Results of a study on team familiarity in a military medical center showed that the expected turnover time decreased when team familiarity increased; however, late starts and expected turnover times increased when a student nurse anesthetist who was unfamiliar with processes joined the team 33 . Effective interprofessional relationships can drive performance and improve outcomes 34 .…”

Section: Discussionmentioning

confidence: 99%

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Retrospective Analysis of Associated Costs and Sources of Variability in OR Utilization Across Weekdays

Elliott‐Dawe,

Chen,

Stucky

et al. 2024

AORN Journal

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Few studies have examined variability in OR utilization across weekdays. We conducted a retrospective analysis to determine OR utilization differences by day of the week and the source and financial effects of any variability. We extracted 55 months of data from a surgical data repository to calculate OR utilization, late starts, idle times, and delays for each weekday. Declines in OR utilization occurred as the week progressed and were attributed to compounding changes in late start, delay, and idle time. The average weekly cost for each OR associated with unused staffed minutes below a target OR utilization of 85% was $19,383, and the comparable lost weekly revenue was $60,256. Perioperative leaders should identify sources of OR utilization variability when developing strategies that enhance outcomes for patients, minimize costs, and maximize revenue.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Retrospective Analysis of Associated Costs and Sources of Variability in OR Utilization Across Weekdays

Elliott‐Dawe,

Chen,

Stucky

et al. 2024

AORN Journal

Self Cite

View full text Add to dashboard Cite

show abstract

“…Because of the different tasks, roles, and perspectives of the team members during an operation, maintaining a shared mental model and high situation awareness may be difficult ( Graafland et al, 2015 ; Afkari et al, 2016 ). Other challenges to good teamwork in the OR are the notoriously high noise levels which may hamper communication ( Keller et al, 2016 ; Leitsmann et al, 2021 ), low team familiarity ( Kurmann et al, 2014 ; Stucky et al, 2021 ) and strong hierarchies, which may hamper psychological safety and diminish speaking up ( Appelbaum et al, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study

et al. 2023

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BackgroundThe team timeout (TTO) is a safety checklist to be performed by the surgical team prior to incision. Exchange of critical information is, however, important not only before but also during an operation and members of surgical teams frequently feel insufficiently informed by the operating surgeon about the ongoing procedure. To improve the exchange of critical information during surgery, the StOP?-protocol was developed: At appropriate moments during the procedure, the leading surgeon briefly interrupts the operation and informs the team about the current Status (St) and next steps/objectives (O) of the operation, as well as possible Problems (P), and encourages questions of other team members (?). The StOP?-protocol draws attention to the team. Anticipating the occurrence of StOP?-protocols may support awareness of team processes and quality issues from the beginning and thus support other interventions such as the TTO; however, it also may signal an additional demand and contribute to a phenomenon akin to “checklist fatigue.” We investigated if, and how, the introduction of the StOP?-protocol influenced TTO quality.MethodsThis was a prospective intervention study employing a pre-post design. In the visceral surgical departments of two university hospitals and one urban hospital the quality of 356 timeouts (out of 371 included operation) was assessed by external observers before (154) and after (202) the introduction of the StOP?-briefing. Timeout quality was rated in terms of timeout completeness (number of checklist items mentioned) and timeout quality (engagement, pace, social atmosphere, noise).ResultsAs compared to the baseline, after the implementation of the StOP?-protocol, observed timeouts had higher completeness ratings (F = 8.69, p = 0.003) and were rated by observers as higher in engagement (F = 13.48, p < 0.001), less rushed (F = 14.85, p < 0.001), in a better social atmosphere (F = 5.83, p < 0.016) and less noisy (F = 5.35, p < 0.022).ConclusionAspects of TTO are affected by the anticipation of StOP?-protocols. However, rather than harming the timeout goals by inducing “checklist fatigue,” it increases completeness and quality of the team timeout.

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Operative time tracking for umbilical hernia patients

2022

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Military Surgical Team Performance: The Impact of Familiarity, Team Size, and Nurse Anesthesia Students

Cited by 11 publications

References 41 publications

Retrospective Analysis of Associated Costs and Sources of Variability in OR Utilization Across Weekdays

Retrospective Analysis of Associated Costs and Sources of Variability in OR Utilization Across Weekdays

No signs of check-list fatigue – introducing the StOP? intra-operative briefing enhances the quality of an established pre-operative briefing in a pre-post intervention study

Operative time tracking for umbilical hernia patients

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