The impact of improving teamwork on patient outcomes in surgery: a systematic review
File(s)manuscript IJS.doc (90 KB)
Accepted version
Author(s)
Sun, Rosa
Marshall, Dominic C
Sykes, Mark C
Maruthappu, Mahiben
Shalhoub, J
Type
Journal Article
Abstract
Background
The aviation industry pioneered formalised crew training in order to improve safety and reduce consequences of non-technical error. This formalised training has been successfully adapted and used to in the field of surgery to improve post-operative patient outcomes. The need to implement teamwork training as an integral part of a surgical programme is increasingly being recognised. We aim to systematically review the impact of surgical teamwork training on post-operative outcomes.
Methods
Two independent researchers systematically searched MEDLINE and Embase in accordance with PRISMA guidelines. Studies were screened and subjected to inclusion/exclusion criteria. Study characteristics and outcomes were reported and analysed.
Results
Our initial search identified 2720 articles. Following duplicate removal, title and abstract screening, 107 full text articles were analysed. Eight articles met our inclusion criteria. Overall, three articles supported a positive effect of good teamwork on post-operative patient outcomes. We identified key areas in study methodology that can be improved upon, including small cohort size, lack of unified training programme, and short training duration, should future studies be designed and implemented in this field.
Conclusion
At present, there is insufficient evidence to support the hypothesis that teamwork training interventions improve patient outcomes. We believe that non-significant and conflicting results can be attributed to flaws in methodology and non-uniform training methods. With increasing amounts of evidence in this field, we predict a positive association between teamwork training and patient outcomes will come to light.
The aviation industry pioneered formalised crew training in order to improve safety and reduce consequences of non-technical error. This formalised training has been successfully adapted and used to in the field of surgery to improve post-operative patient outcomes. The need to implement teamwork training as an integral part of a surgical programme is increasingly being recognised. We aim to systematically review the impact of surgical teamwork training on post-operative outcomes.
Methods
Two independent researchers systematically searched MEDLINE and Embase in accordance with PRISMA guidelines. Studies were screened and subjected to inclusion/exclusion criteria. Study characteristics and outcomes were reported and analysed.
Results
Our initial search identified 2720 articles. Following duplicate removal, title and abstract screening, 107 full text articles were analysed. Eight articles met our inclusion criteria. Overall, three articles supported a positive effect of good teamwork on post-operative patient outcomes. We identified key areas in study methodology that can be improved upon, including small cohort size, lack of unified training programme, and short training duration, should future studies be designed and implemented in this field.
Conclusion
At present, there is insufficient evidence to support the hypothesis that teamwork training interventions improve patient outcomes. We believe that non-significant and conflicting results can be attributed to flaws in methodology and non-uniform training methods. With increasing amounts of evidence in this field, we predict a positive association between teamwork training and patient outcomes will come to light.
Date Issued
2018-03-22
Date Acceptance
2018-03-20
Citation
International Journal of Surgery, 2018, 53, pp.171-177
ISSN
1743-9191
Publisher
Elsevier
Start Page
171
End Page
177
Journal / Book Title
International Journal of Surgery
Volume
53
Copyright Statement
© 2018 Elsevier Ltd. All rights reserved. This manuscript is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License http://creativecommons.org/licenses/by-nc-nd/4.0/
Subjects
Intervention
Outcome
Post-operative
Surgery
Teamwork
Training
1103 Clinical Sciences
Publication Status
Published