Surgical team behaviors and patient outcomes
Abstract Background Little evidence exists that links teamwork to patient outcomes. We conducted this study to determine if patients of teams with good teamwork had better outcomes than those with poor teamwork. Methods Observers used a standardized instrument to assess team behaviors. Retrospective...
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| Veröffentlicht in: | The American journal of surgery 2009-05, Vol.197 (5), p.678-685 |
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| creator | Mazzocco, Karen, R.N., J.D Petitti, Diana B., M.D., M.P.H Fong, Kenneth T., M.S Bonacum, Doug, M.B.A Brookey, John, M.D Graham, Suzanne, R.N., Ph.D Lasky, Robert E., Ph.D Sexton, J. Bryan, Ph.D Thomas, Eric J., M.D., M.P.H |
| description | Abstract Background Little evidence exists that links teamwork to patient outcomes. We conducted this study to determine if patients of teams with good teamwork had better outcomes than those with poor teamwork. Methods Observers used a standardized instrument to assess team behaviors. Retrospective chart review was performed to measure 30-day outcomes. Multiple logistic regressions were calculated to assess the independence of the association between teamwork with patient outcome after adjusting for American Society of Anesthesiologists (ASA) score. Results In univariate analyses, patients had increased odds of complications or death when the following behaviors were exhibited less frequently: information sharing during intraoperative phases, briefing during handoff phases, and information sharing during handoff phases. Composite measures of teamwork across all operative phases were significantly associated with complication or death after adjusting for ASA score (odds ratio 4.82; 95% confidence interval, 1.30–17.87). Conclusion When teams exhibited infrequent team behaviors, patients were more likely to experience death or major complication. |
| doi_str_mv | 10.1016/j.amjsurg.2008.03.002 |
| format | Article |
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Bryan, Ph.D ; Thomas, Eric J., M.D., M.P.H</creator><creatorcontrib>Mazzocco, Karen, R.N., J.D ; Petitti, Diana B., M.D., M.P.H ; Fong, Kenneth T., M.S ; Bonacum, Doug, M.B.A ; Brookey, John, M.D ; Graham, Suzanne, R.N., Ph.D ; Lasky, Robert E., Ph.D ; Sexton, J. Bryan, Ph.D ; Thomas, Eric J., M.D., M.P.H</creatorcontrib><description>Abstract Background Little evidence exists that links teamwork to patient outcomes. We conducted this study to determine if patients of teams with good teamwork had better outcomes than those with poor teamwork. Methods Observers used a standardized instrument to assess team behaviors. Retrospective chart review was performed to measure 30-day outcomes. Multiple logistic regressions were calculated to assess the independence of the association between teamwork with patient outcome after adjusting for American Society of Anesthesiologists (ASA) score. Results In univariate analyses, patients had increased odds of complications or death when the following behaviors were exhibited less frequently: information sharing during intraoperative phases, briefing during handoff phases, and information sharing during handoff phases. Composite measures of teamwork across all operative phases were significantly associated with complication or death after adjusting for ASA score (odds ratio 4.82; 95% confidence interval, 1.30–17.87). Conclusion When teams exhibited infrequent team behaviors, patients were more likely to experience death or major complication.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2008.03.002</identifier><identifier>PMID: 18789425</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Airline industry ; Anesthesiology ; Aviation ; Behavior ; Behavioral markers ; Biological and medical sciences ; Calibration ; Communication ; Complications ; Confidence intervals ; Consent ; Death ; Female ; General aspects ; Health care ; Human factors ; Humans ; Logistic Models ; Male ; Medical personnel ; Medical sciences ; Middle Aged ; Mortality ; Nurses ; Operating room ; Operating Rooms - organization & administration ; Outcome Assessment (Health Care) ; Patient Care Team ; Patient outcomes ; Patient safety ; Patients ; Phases ; Qualitative research ; Regression analysis ; Retrospective Studies ; Surgeons ; Surgery ; Surgery Department, Hospital - organization & administration ; Teaching hospitals ; Team behavior ; Teams ; Teamwork ; United States ; Young Adult</subject><ispartof>The American journal of surgery, 2009-05, Vol.197 (5), p.678-685</ispartof><rights>Elsevier Inc.</rights><rights>2009 Elsevier Inc.</rights><rights>2009 INIST-CNRS</rights><rights>Copyright Elsevier Limited May 1, 2009</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-b961858b009784c3df79882afcb0ae07ce4c5d482530662ddf9822936bcb05ea3</citedby><cites>FETCH-LOGICAL-c476t-b961858b009784c3df79882afcb0ae07ce4c5d482530662ddf9822936bcb05ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1924855001?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997,64387,64389,64391,72471</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=21431568$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18789425$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mazzocco, Karen, R.N., J.D</creatorcontrib><creatorcontrib>Petitti, Diana B., M.D., M.P.H</creatorcontrib><creatorcontrib>Fong, Kenneth T., M.S</creatorcontrib><creatorcontrib>Bonacum, Doug, M.B.A</creatorcontrib><creatorcontrib>Brookey, John, M.D</creatorcontrib><creatorcontrib>Graham, Suzanne, R.N., Ph.D</creatorcontrib><creatorcontrib>Lasky, Robert E., Ph.D</creatorcontrib><creatorcontrib>Sexton, J. Bryan, Ph.D</creatorcontrib><creatorcontrib>Thomas, Eric J., M.D., M.P.H</creatorcontrib><title>Surgical team behaviors and patient outcomes</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Abstract Background Little evidence exists that links teamwork to patient outcomes. We conducted this study to determine if patients of teams with good teamwork had better outcomes than those with poor teamwork. Methods Observers used a standardized instrument to assess team behaviors. Retrospective chart review was performed to measure 30-day outcomes. Multiple logistic regressions were calculated to assess the independence of the association between teamwork with patient outcome after adjusting for American Society of Anesthesiologists (ASA) score. Results In univariate analyses, patients had increased odds of complications or death when the following behaviors were exhibited less frequently: information sharing during intraoperative phases, briefing during handoff phases, and information sharing during handoff phases. Composite measures of teamwork across all operative phases were significantly associated with complication or death after adjusting for ASA score (odds ratio 4.82; 95% confidence interval, 1.30–17.87). Conclusion When teams exhibited infrequent team behaviors, patients were more likely to experience death or major complication.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Airline industry</subject><subject>Anesthesiology</subject><subject>Aviation</subject><subject>Behavior</subject><subject>Behavioral markers</subject><subject>Biological and medical sciences</subject><subject>Calibration</subject><subject>Communication</subject><subject>Complications</subject><subject>Confidence intervals</subject><subject>Consent</subject><subject>Death</subject><subject>Female</subject><subject>General aspects</subject><subject>Health care</subject><subject>Human factors</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical personnel</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Nurses</subject><subject>Operating room</subject><subject>Operating Rooms - organization & administration</subject><subject>Outcome Assessment (Health Care)</subject><subject>Patient Care Team</subject><subject>Patient outcomes</subject><subject>Patient safety</subject><subject>Patients</subject><subject>Phases</subject><subject>Qualitative research</subject><subject>Regression analysis</subject><subject>Retrospective Studies</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surgery Department, Hospital - organization & administration</subject><subject>Teaching hospitals</subject><subject>Team behavior</subject><subject>Teams</subject><subject>Teamwork</subject><subject>United States</subject><subject>Young Adult</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2009</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkVuL1jAQhoMo7rerP0EpiF7ZOjk2uVFkWQ-w4MXqdUjTqab28Jm0C_vvTfmKC3vjVUh45s3MM4S8oFBRoOpdX7mxT2v8WTEAXQGvANgjcqC6NiXVmj8mB8hPpVEUzsh5Sn2-Uir4U3KWIW0Ekwfy9iZHBO-GYkE3Fg3-crdhjqlwU1sc3RJwWop5Xfw8YnpGnnRuSPh8Py_Ij09X3y-_lNffPn-9_HhdelGrpWzyl1rqBsDUWnjedrXRmrnON-AQao_Cy1ZoJjkoxdq2M5oxw1WTAYmOX5A3p9xjnP-smBY7huRxGNyE85qsqqnSNYgMvnoA9vMap9ybpYYJLWUeOVPyRPk4pxSxs8cYRhfvLAW7ybS93WXaTaYFbrO5XPdyT1-bEdv7qt1eBl7vgEtZYRfd5EP6x7Esm0qlM_fhxGGWdhsw2uSzWI9tiOgX287hv628f5DghzBte_uNd5jup7aJWbA32-a3xYMGENJI_hcXKqfe</recordid><startdate>20090501</startdate><enddate>20090501</enddate><creator>Mazzocco, Karen, R.N., J.D</creator><creator>Petitti, Diana B., M.D., M.P.H</creator><creator>Fong, Kenneth T., M.S</creator><creator>Bonacum, Doug, M.B.A</creator><creator>Brookey, John, M.D</creator><creator>Graham, Suzanne, R.N., Ph.D</creator><creator>Lasky, Robert E., Ph.D</creator><creator>Sexton, J. Bryan, Ph.D</creator><creator>Thomas, Eric J., M.D., M.P.H</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20090501</creationdate><title>Surgical team behaviors and patient outcomes</title><author>Mazzocco, Karen, R.N., J.D ; Petitti, Diana B., M.D., M.P.H ; Fong, Kenneth T., M.S ; Bonacum, Doug, M.B.A ; Brookey, John, M.D ; Graham, Suzanne, R.N., Ph.D ; Lasky, Robert E., Ph.D ; Sexton, J. 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Bryan, Ph.D</au><au>Thomas, Eric J., M.D., M.P.H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical team behaviors and patient outcomes</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2009-05-01</date><risdate>2009</risdate><volume>197</volume><issue>5</issue><spage>678</spage><epage>685</epage><pages>678-685</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Abstract Background Little evidence exists that links teamwork to patient outcomes. We conducted this study to determine if patients of teams with good teamwork had better outcomes than those with poor teamwork. Methods Observers used a standardized instrument to assess team behaviors. Retrospective chart review was performed to measure 30-day outcomes. Multiple logistic regressions were calculated to assess the independence of the association between teamwork with patient outcome after adjusting for American Society of Anesthesiologists (ASA) score. Results In univariate analyses, patients had increased odds of complications or death when the following behaviors were exhibited less frequently: information sharing during intraoperative phases, briefing during handoff phases, and information sharing during handoff phases. Composite measures of teamwork across all operative phases were significantly associated with complication or death after adjusting for ASA score (odds ratio 4.82; 95% confidence interval, 1.30–17.87). Conclusion When teams exhibited infrequent team behaviors, patients were more likely to experience death or major complication.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>18789425</pmid><doi>10.1016/j.amjsurg.2008.03.002</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult Aged Airline industry Anesthesiology Aviation Behavior Behavioral markers Biological and medical sciences Calibration Communication Complications Confidence intervals Consent Death Female General aspects Health care Human factors Humans Logistic Models Male Medical personnel Medical sciences Middle Aged Mortality Nurses Operating room Operating Rooms - organization & administration Outcome Assessment (Health Care) Patient Care Team Patient outcomes Patient safety Patients Phases Qualitative research Regression analysis Retrospective Studies Surgeons Surgery Surgery Department, Hospital - organization & administration Teaching hospitals Team behavior Teams Teamwork United States Young Adult |
| title | Surgical team behaviors and patient outcomes |
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