A Strategic Core Role Perspective on Team Coordination: Benefits of Centralized Leadership for Managing Task Complexity in the Operating Room

Objective We examine whether surgical teams can handle changes in task requirements better when their formal leader and strategic core role holder—that is, the main surgeon—is central to team coordination. Background Evidence regarding the benefits of shared leadership for managing complex tasks is divided. We tested whether a strategic core role holder’s centrality in team coordination helps teams to handle different types of task complexity. Method We observed coordination as specific leadership behavior in 30 surgical teams during real-life operations. To assess the strategic core role holder’s coordination centrality, we conducted social network analyses. Task complexity (i.e., surgical difficulty and unexpected events) and surgical goal attainment were rated in a questionnaire. Results In the critical operation phase, surgical difficulty impaired goal attainment when the strategic core role holder’s coordination centrality was low, while this effect was nonsignificant when his/her coordination centrality was high. Unexpected events had a negative effect on surgical goal attainment. However, coordination centrality of the strategic core role holder could not help manage unexpected events. Conclusion The results indicate that shared leadership is not beneficial when teams face surgical difficulty during the critical operation phase. In this situation, team coordination should rather be centralized around the strategic core role holder. Contrarily, when unexpected events occur, centralizing team coordination around a single leader does not seem to be beneficial for goal attainment. Application Leaders and team members should be aware of the importance of distributing leadership differently when it comes to managing different types of task complexity.