Improving the Effectiveness of Surgical Teams

Covid-19, hospital teams, healthcare workers, healthcare systems, surgical team performance, Banksy and the new heroes of the pandemic

Profs. Yufei Huang, Trinity Business School, Emmanouil Avgerinos of IE Business School, and Ioannis Fragkos at Rotterdam School of Management, Erasmus University, share Part 1 of their research into boosting the team performance of our new heroes.

By Tom Gamble from the paper Team familiarity in cardiac surgery operations: The effects of hierarchy and failure on team productivity, by Yufei Huang, Trinity College Dublin, Ireland, Emmanouil Avgerinos IE University, Spain and Ioannis Fragkos at Rotterdam School of Management, Erasmus University, Netherlands. SAGE. With acknowledgements to Ian Dunne at Trinity College Dublin.

Read Part 2 of this article

New heroes, new healthcare focus

The importance of healthcare team performance has never before been put more to the test. In western countries, public outcry and pressure in support of healthcare systems and the people working within them during the Covid-19 pandemic has been enormous – epitomized by the now famous Banksy artwork given as a gift to the NHS in England and homage to the new heroes of our age. It has also refocused attention on the overstretched and limited resources that have been a result of 30 years of cost-cutting in the name of economic efficiency. 

Covid-19, hospital teams, healthcare workers, healthcare systems, surgical team performance, Banksy and the new heroes of the pandemic
Copyright Banksy, 2020

Indeed, not so far back, when asked to comment of the 180% rise in the number of patients waiting six months for an operation, Clare Marx, former President of the UK’s Royal College of Surgeons, admitted that the National Health Service (NHS) was struggling to meet the standards and timeliness of care that the public rightly expected, condemning as unacceptable the large number of patients waiting in pain and discomfort for treatment. Perhaps, as one of the positive outcomes of the Covid-19 crisis, the plea for greater resources and respect for our healthcare systems might now be directly addressed.     

In addition to more people and more money, it is the management of the healthcare system that can positively contribute to making things better for both healthcare systems, its employees and the wider public they serve. Drilling down to micro-level, there is much to be learnt and put into practice from the study of healthcare teams in the very front line. And this is what researchers Professor-researchers Yufei Huang, Emmanouil Avgerinos and Ioannis Fragkos set out to explore.

Teams and what makes them tick

It comes as no surprise that teams are the focus for much research and much literature. From startups to MNCs, the military and healthcare, teams are a cornerstone for the bigger system and its search for high performance. Their role in frontline operations makes them answerable to productivity and efficiency, success or failure.

Covid-19, hospital teams, healthcare workers, healthcare systems, surgical team performance, Banksy and the new heroes of the pandemic
Stitching together a team

Let’s take three of the many dimensions said to influence team success and productivity. One is the extent to which team members know each and have worked together on previous occasions. This is known as team familiarity. But managers who battle to keep their teams intact while aiming at high productivity may often realise that this past shared experience is only part of the answer.

A second is hierarchy. From the boss flexing his/her muscles to subordinates in a show of power, to playing on status and effective leadership style, hierarchy has an impact on the key aspects of communication, decision-making and behaviour.

And finally, a third dimension is that of failure, or what the modern manager might euphemistically term ‘non-success’. Failure can lead to the adoption of new policies and strategies, though researchers Huang, Avgerinos Fragkos assert that we know little about whether team failures generate experiences with a detrimental or beneficial effect on productivity.

Cardiac teams: The heart of the matter

Surgical teams – and at the heart of Huang et al research, cardiac teams – are interesting. Which is why much research has used them as standard benchmarks from which to measure productivity, high-quality patient care and patient-waiting time. They are highly dynamic, work in highly complex contexts and they have daunting life-or-death decisions to make. They’re also special in that they bring together a great variety of individual roles and skills – from scrub-nurse to anaesthesiologist – topped by an authoritative figure of expertise, the surgeon.

Covid-19, hospital teams, healthcare workers, healthcare systems, surgical team performance, Banksy and the new heroes of the pandemic
Don’t lose heart

The job of operating carries with it a profusion of complex non-routine tasks that require considerable coordination among group members. Add to that the challenge of achieving collective performance while being subject to short life span: surgical teams are dissolved after an operation, only to form again upon another occasion often incorporating members from other teams.

And finally, cardiac operations require a high level of task interdependence, the actions of individual surgical team members carrying an impact on others’ outcomes, with no team member being able to guarantee a good outcome on its own. So what makes them work? And more to the point, what ensures effectiveness, productivity and successful outcomes – the saving of a person’s life?

Yufei Huang, Covid-19, hospital teams, healthcare workers, healthcare systems, surgical team performance, Banksy and the new heroes of the pandemic
Prof. Yufei Huang

In Part 2 of this article, tomorrow June 19th, what vertical and horizontal familiarity can tell us, why surgical team failure and patient death give more effective surgical teams, and how this research gives a magical figure of 18 minutes, 37 seconds.

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