Teamwork Helps Surgeons Learn Procedures Faster

According to a recent study, surgical teams that emphasize teamwork and organizational learning in adopting a new procedure are likely to learn faster than others with equivalent experience. The study, conducted by researchers at Harvard Business School (Cambridge, MS, USA), was reported in the August 2001 issue of Management Science (published by the Institute for Operations Research and the Management Sciences, INFORMS).

To examine learning rates, the authors analyzed data on a new minimally invasive cardiac surgery procedure performed on 660 patients at 16 different hospitals. All the hospitals received the same three-day training session before performing the operation. The study focused only on a single dimension of learning: reduction in the time required to perform a new procedure.

As one of the fastest learners in the study, the authors cite a community hospital performing 1,200 cardiac operations a year. The surgeon who adopted the procedure for the hospital handpicked the members of the operating team based on their prior experience and their demonstrated ability to work as a group. Team members practiced a high degree of cross-departmental communication and cooperation even before the first operation. To further foster teamwork, the adopting surgeon made sure the team members who took the training program performed the first 15 cases together before any new team members were changed.

In contrast, one of the worst performing hospitals was a nationally renowned academic medical center where team members were picked largely on the basis of availability. Only three of the four core team members who attended the training program were present for the first case, and there were no meetings to discuss the case before operations. As a result, the staff involved with the procedure did not bond. Moreover, the lead surgeon shunned the kind of repetition that helps medical professionals master a difficult procedure, explaining "I try to do something new on every case.”

The surgical team that practiced teamwork actually had a lower-than-average predicted procedure time for its first seven cases. However, by case 50, the team was able to undertake a comparable procedure significantly faster than the typical team in the study sample. The estimated net adjusted procedure time for this hospital at case 50 was about 132 minutes, versus 220 minutes for the sample average.

The authors note that an organization with less cumulative experience than its rivals can still achieve a performance advantage if it more thoroughly exploits its opportunities for learning. "The surgeon needs to be willing to allow himself to become a partner [with the rest of the team] so he can accept input,” explained one doctor on the team that practiced teamwork.





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