Paper Operative Team Familiarity and Specialization at an Academic Medical Center

Objective: 
To propose a framework for quantification of surgical team familiarity.

Background: 
Operating room (OR) teamwork quality is associated with familiarity among team members and their individual specialization. We describe novel measures of OR team familiarity and specialty experience.

Methods: 
Surgeon-scrub (SS) and surgeon-circulator (SC) teaming scores, defined as the pair’s proportion of interactions relative to the surgeon’s total cases in the preceding 6 months were calculated between 2017 and 2021 at an academic medical center. Nurse service-line (SL) experience scores were defined as the proportion of a nurse’s cases performed within the given specialty. SS, SC, and nurse-SL scores were analyzed by specialty, case urgency, robotic approach, and surgeon academic rank. Two-sample Kolmogorov-Smirnov tests were used to determine heterogeneity between distributions.

Results: 
A total of 37,364 operations involving 150 attending surgeons and 222 nurses were analyzed. Median SS and SC scores were 0.08 (interquartile range: 0.03–0.19) and 0.06 (interquartile range: 0.03–0.13), respectively. Higher margin SLs, senior faculty rank, elective, and robotic cases were associated with greater SS, SC, and nurse-SL scores (P<0.001).

Conclusions: 
These novel measures of teaming and specialization illustrate the low levels of OR team familiarity and objectively highlight differences that necessitate a deliberate evaluation of current OR scheduling practices.

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