Prior Collaboration Between Surgeons and Anesthesiologists Reduces Patient Complications

Recent research indicates that the likelihood of complications following high-risk surgeries decreases when surgeons and anesthesiologists have previously collaborated. This finding stems from a comprehensive study conducted by researchers associated with ICES, Sunnybrook Research Institute, and the University of Toronto.

The study involved an extensive analysis of data from over 700,000 high-risk surgical procedures performed in Ontario over a decade, coupled with insights into the working relationships of the surgical teams involved. Published in JAMA Surgery, the research underscores the advantages of team dynamics in enhancing patient outcomes.

According to the lead researcher, the concept of team design, commonly utilized in sectors like business and sports, is often neglected in healthcare settings. It is not uncommon for medical professionals who have never previously worked together to be expected to perform optimally in high-pressure situations.

To investigate this phenomenon, researchers analyzed population-based healthcare data covering 711,005 elective surgeries that posed significant risks, conducted between 2009 and 2019. They examined the frequency with which specific surgeon-anesthesiologist pairs had collaborated prior to each procedure.

The analysis revealed a notable correlation between the familiarity of surgical teams and the incidence of severe complications within 90 days following surgery, particularly for operations related to the gastrointestinal tract, spine, and gynecological cancers. For each additional procedure performed by a given surgeon-anesthesiologist duo, the likelihood of severe complications diminished by 3% to 8%. These findings are significant, as serious postoperative complications can lead to extended hospital stays, further surgical interventions, or even mortality.

Interestingly, it was noted that on average, most surgeon-anesthesiologist pairs only worked together three times a year. In contrast, those involved in orthopedic and cardiac surgeries exhibited higher levels of familiarity, averaging eight and nine procedures together annually, respectively. This consistency in teaming up for specific surgeries stems from the specialized training required for anesthesiologists to assist in cardiac procedures and the concentrated nature of orthopedic surgeries in specialized facilities.

These results suggest that, unlike costly medical technologies or pharmaceuticals, enhancing the composition of surgical teams to promote familiarity among team members could be a cost-effective strategy to improve patient outcomes. However, the researchers acknowledge potential challenges in adopting a team-oriented approach. A concern arises that anesthesiologists, who are predominantly considered generalists, may become more specialized and less adaptable to diverse surgical roles.

Future research will focus on exploring these challenges and identifying additional factors that could facilitate the establishment of more stable surgical teams. The research team is currently engaging with anesthesiologists and surgeons to gather insights on various care models and to address concerns necessary for implementing this innovative approach. They are also conducting a cost analysis to evaluate potential savings for hospitals and healthcare systems through the creation of more familiar surgical teams and a reduction in postoperative complications.

Ultimately, the study highlights that fostering consistent teamwork in the operating room cannot be simulated through protocols or guidelines; true familiarity and effectiveness come from repeated collaboration among medical professionals.