The greater the familiarity between a surgeon and an anesthesiologist was linked to improved outcomes for patients in certain surgeries, MedPage Today reported May 28.
The retrospective study was conducted by physicians of Sunnybrook Health Sciences Centre in Toronto, Canada, but the results may be informative for surgical teams in the U.S. The study was originally published in JAMA Surgery May 28.
The study looked at 711,000 index procedures, and an independent association was observed between surgeon-anesthesiologist dyad volume and 90-day major morbidity after adjusting for hospital setting, hospital surgeon and anesthesiologist volume and patient age, sex and comorbidity burden. The study focused on outcomes for high-risk gastrointestinal surgeries, low-risk gastrointestinal surgeries, gynecology oncology surgery and spine surgery.
Surgeon-anesthesiologist pairs who are familiar with each other “develop shared mental models, trust, and more efficient communication, allowing them to anticipate each other’s needs, manage crises more effectively, and minimize errors,” Julie Hallet, MD, one of the researchers on the study, told Medpage.
“Familiarity can also streamline workflow, reduce disruptions, and encourage mutual support in the operating room, all of which enhance technical and non-technical performance during surgery,” she added.
The researchers also found that more familiar teams were more likely to stick to best practices and care processes and effectively respond to unanticipated events.
The associations between surgeon-anesthesiologist dyad volume and 90-day major morbidity varied across procedures. The researchers told Medpage that this may point to different structures of care and different baseline risks and management. For example, no significant association was seen for procedures where the median dyad volume was high, such as cardiac, lung and orthopedic surgeries.
“Structures of care for these procedures are unique within our system, with higher dyad volume and familiarity overall,” the researchers said. They also acknowledged that challenges may exist to scheduling more familiar teams together.
“Barriers include scheduling complexity, workforce constraints, and competing priorities in work organization. Implementing dedicated surgical-anesthesia teams could disrupt current models, and might require investment in personnel flexibility, staffing buffers, or even dedicated teams for certain procedures,” Dr. Hallet said. “However, these changes could be both beneficial for patients and cost-effective if they reduce post-op complications that are resource-intensive.”
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