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Outcomes/Effectiveness Research

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Surgery patients have better outcomes when their surgical team communicates and collaborates

Good communication and collaboration among surgical team members is linked to better patient outcomes 30 days after surgery, according to a new study. Yet organizational climate safety factors (OCSFs), including perception of organizational commitment to patient safety and working conditions and job satisfaction, were not linked to patient outcomes.

The researchers administered surveys to staff on general/vascular surgery units of 44 Veterans Affairs and 8 academic medical centers during a year. They used the Safety Attitudes Questionnaire (SAQ) to measure staff perceptions of teamwork, job satisfaction, management, safety climate (organizational commitment to patient safety), working conditions, and recognition of stress effects on clinical teams. They also surveyed staff about how they perceived communication and collaboration with attending and resident doctors.

Patients of surgical teams reporting higher levels of communication and collaboration with the attending and resident doctors had fewer postoperative complications up to 30 days after the operation, after adjusting for other factors affecting patient outcomes. However, this team communication and collaboration was not linked to fewer patient postoperative deaths. None of the OCSFs correlated with risk-adjusted patient outcomes.

The authors suggest that OCSFs themselves may influence patient outcomes; however, the survey-based scales used to measure them can be inadequate. The study was supported by the Agency for Healthcare Research and Quality (HS11913 and HS12029).

More details are in "Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communications and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions," by Daniel L. Davenport, Ph.D., William G. Henderson, Ph.D., Cecilia L. Mosca, M.P.H., and others, in the December 2007 Journal of the American College of Surgeons 205, pp. 778-784.

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