Teamwork characterizes surgical teams that are faster learners of new procedures, suggests O.R. study

ere were no meetings to discuss cases before operations.

The staff involved with the procedure didn't bond. Said one nurse, "We don't have any real teams here. It's just who gets assigned on any given day."

Not only was team membership unstable during early operations, but the surgeon compounded learning difficulties by shunning the kind of repetition that helps medical professionals master a difficult procedure, explaining "I try to do something new on every case."

Different Rates of Organizational Learning
The study maintains that organizational learning processes allow some organizations to benefit more than others from equivalent levels of experience. The authors argue that learning curves can vary across organizations engaged in the same learning task due to organizational learning.

To investigate, they examined cardiac surgery departments implementing a new technology for minimally invasive cardiac surgery. In contrast to conventional surgery, in which the roles of each team member are well established, the new procedure expanded the roles of non-surgeons assisting the operation.

The study focused on a single dimension of learning: reduction in the time required to perform the new procedure.

Procedure time is the single most important factor driving the total costs of treating and caring for a cardiac surgery patient, the authors write. Procedure time is also a good indicator of the way an organization, rather than individuals, learns. And reducing procedure time is desirable for the patient's well being.

To examine learning rates, the authors analyzed data on operative procedure times from a sample of 660 patients who underwent the new operation at 16 different institutions. All the teams participating were chosen because they were regarded as excellent in their field. All adopting hospitals received the same three-day training session before performing the operation.

The authors constructed four mathematical

Contact: Barry List
Institute for Operations Research and the Management Sciences

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