BACKGROUND: Bariatric surgery durations vary considerably because of differences in surgical procedures and patient factors. We studied the effects on patient outcomes, teamwork and safety climate, and procedure durations resulting from working with operating room (OR) teams that remain fixed for the day instead of OR teams that vary during the day. METHODS: Data were collected in 2 general teaching hospitals, consisting of patientrelated demographic and intraoperative data and of staffrelated survey data on team work and safety climate. The procedure durations of fixed and conventional OR teams were analyzed by comparison of means tests and by regression methods to control for the effects of surgeon, surgical experience, and procedure type. RESULTS: For both hospitals, we obtained the following 4 results for working on bariatric procedures with OR teams that remained fixed for the day. First, patient outcomes did not worsen. Second, teamwork and safety climate (both measured on a 5-point scale) improved significantly, for teamwork + 0.86 (95% confidence interval [CI], 0.54 to 1.18) and for safety climate + 0.75 (95% CI, 0.40 to 1.11). Third, the procedures were performed significantly faster, as both the mean and the SD of procedure durations decreased. After correcting for learning effects, the average reduction of durations was 10.8% (99% CI, 5.0% to 15.3%, or 4 to 13 minutes). This gain was mainly realized for surgical time (12%; 99% CI, 5% to 18%, or 3 to 11 minutes). The effect on peripheral time, defined as procedure time minus surgical time, is not significant (3%; 99% CI, -6% to 12%, or -1 to 3 minutes). Fourth, additional gains were obtained by performing the same type of procedure multiple times within the same day (5% per every next procedure of the same type; 99% CI, 3% to 7%, or 3 to 6 minutes). CONCLUSIONS: Working with fixed teams in bariatric surgery reduced procedure durations and improved teamwork and safety climate, without adverse effects on patient outcomes.
BACKGROUND: Bariatric surgery durations vary considerably because of differences in surgical procedures and patient factors. We studied the effects on patient outcomes, teamwork and safety climate, and procedure durations resulting from working with operating room (OR) teams that remain fixed for the day instead of OR teams that vary during the day. METHODS: Data were collected in 2 general teaching hospitals, consisting of patientrelated demographic and intraoperative data and of staffrelated survey data on team work and safety climate. The procedure durations of fixed and conventional OR teams were analyzed by comparison of means tests and by regression methods to control for the effects of surgeon, surgical experience, and procedure type. RESULTS: For both hospitals, we obtained the following 4 results for working on bariatric procedures with OR teams that remained fixed for the day. First, patient outcomes did not worsen. Second, teamwork and safety climate (both measured on a 5-point scale) improved significantly, for teamwork + 0.86 (95% confidence interval [CI], 0.54 to 1.18) and for safety climate + 0.75 (95% CI, 0.40 to 1.11). Third, the procedures were performed significantly faster, as both the mean and the SD of procedure durations decreased. After correcting for learning effects, the average reduction of durations was 10.8% (99% CI, 5.0% to 15.3%, or 4 to 13 minutes). This gain was mainly realized for surgical time (12%; 99% CI, 5% to 18%, or 3 to 11 minutes). The effect on peripheral time, defined as procedure time minus surgical time, is not significant (3%; 99% CI, -6% to 12%, or -1 to 3 minutes). Fourth, additional gains were obtained by performing the same type of procedure multiple times within the same day (5% per every next procedure of the same type; 99% CI, 3% to 7%, or 3 to 6 minutes). CONCLUSIONS: Working with fixed teams in bariatric surgery reduced procedure durations and improved teamwork and safety climate, without adverse effects on patient outcomes.
Authors: Denise M D Özdemir-van Brunschot; Michiel C Warlé; Michel F van der Jagt; Janneke P C Grutters; Sharon B C E van Horne; Heinrich J Kloke; Johannes A van der Vliet; Johan F Langenhuijsen; Frank C d'Ancona Journal: World J Urol Date: 2014-11-02 Impact factor: 4.226
Authors: Guido H H Mannaerts; Rowaa E A Allatif; Fatima Y Al Hashmi; Arati Bhosale; Ahmad N Hammo; Sujoud H Isied; Warda A Qureshi; Omar S Al Hamad; Yasser Kayyal; Hmouda S T Al Afari Journal: Obes Surg Date: 2019-07 Impact factor: 4.129
Authors: Guido H H Mannaerts; Stefanie R van Mil; Pieter S Stepaniak; Martin Dunkelgrün; Marcel de Quelerij; Serge J Verbrugge; Hans F Zengerink; L Ulas Biter Journal: Obes Surg Date: 2016-02 Impact factor: 4.129
Authors: Hugo Meunier; Yannick Le Roux; Anne-Lise Fiant; Yoann Marion; Adrien Lee Bion; Thomas Gautier; Nicolas Contival; Jean Lubrano; Fabienne Fobe; Marion Zamparini; Marie-Astrid Piquet; Véronique Savey; Arnaud Alves; Benjamin Menahem Journal: Obes Surg Date: 2019-09 Impact factor: 4.129
Authors: Sephalie Y Patel; Rosemarie E Garcia Getting; Brandon Alford; Karim Hussein; Braydon J Schaible; David Boulware; Jae K Lee; Scott M Gilbert; Julio M Powsang; Wade J Sexton; Philippe E Spiess; Michael A Poch Journal: World J Surg Date: 2018-09 Impact factor: 3.352