Aim: To systematically review available literature assessing the effect of surgical teamwork on post-operative patient outcomes across a variety of surgical specialties.

Methods: Two independent researchers systematically searched Medline and EMBASE in accordance with PRISMA guidelines. Studies were screened for relevance, then subjected to inclusion and exclusion criteria. Study characteristics and outcomes were reported and discussed qualitatively.

Results: Following PRISMA guidelines, our initial search identified 2519 articles. 105 articles remained after duplicate removal and screening. 11 articles were fully reviewed following addition of exclusion and inclusion criteria. Six studies adopted the use of teamwork training intervention; three studies assessed outcomes based on the familiarity of teams, and two studies correlated teamwork quality with patient outcome. Overall, seven papers demonstrated a positive effect of teamwork on patient outcomes, of which five were significant. Two papers found mixed improvements and deteriorations, two papers found no correlation. There exists considerable heterogeneity in methodology, study characteristics and design.

Conclusions: The positive effect of teamwork on surgical patient outcome is overall supported. Insignificant and opposing results are likely due to inadequate methodology and study design. Common reasons identified are cohort size, lack of a validated training programme, length of training and follow-up time, and non-randomization.