The composition of surgical teams in the operating room and its impact on surgical team performance in China.

Background: Previous studies on surgical team composition have shown that surgical team size had an independent impact on surgical performance in US and Canadian hospitals. We aimed to investigate the impact of team composition on surgical performance in two Chinese hospitals.

Methods: General surgery procedures performed from April 2011 to June 2012 were retrospectively reviewed to record the number of attendees in the operating room (OR) and the procedure time (PT).

Results: A total of 1,900 valid procedures, mostly laparoscopic, were performed during the study period. The mean PT was 90.5 min. On average, there were a total of 6 (range = 3-8) team members per procedure: 3 (range = 1-5) surgeons, 2 nurses, and 1 anesthesiologist. Unlike the data reported for the US and Canada, the number of nurses and anesthesiologists remained stable in most cases, whereas the number of surgeons differed by procedure. Multiple-regression analysis revealed that both the complexity of the operation and the team size significantly affected PT. When procedure complexity and patient condition were kept constant, adding one team member in our data analysis predicted an increase of 34.7 min in the PT.

Conclusion: The surgical team size has a measurable effect on PT. Aside from surgical complexity, the team composition and member stability affected PT in the OR. Optimizing surgical teams and developing a strategy to maintain team stability are of great importance for improving OR efficiency.