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How operating room efficiency is understood in a surgical team: a qualitative study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Colorectal Surgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Health Services Research.
2011 (English)In: International Journal for Quality in Health Care, ISSN 1353-4505, E-ISSN 1464-3677, Vol. 23, no 1, 100-106 p.Article in journal (Refereed) Published
Abstract [en]

Objective. Building surgical teams is one attempt to ensure the health-care system becomes more efficient, but how is 'efficiency'understood or interpreted? The aim was to study how organized surgical team members and their leaders understood operating room efficiency.

Design. Qualitative study.

Settings. A 1100-bed Swedish university hospital.

Participants. Eleven participants, nine team members from the same team and their two leaders were interviewed.

Methods. The analysis was performed according to phenomenography, a research approach that aims to discover variationsin peoples' understanding of a henomenon.

Results. Seven ways of understanding operating room efficiency were identified: doing one's best from one's prerequisites,enjoying work and adjusting it to the situation, interacting group performing parallel tasks, working with minimal resources to produce desired results, fast work with preserved quality, long-term effects for patient care and a relative concept. When talking about the quality and benefits of delivered care, most team members invoked the patient as the central focus. Despite seven ways of understanding efficiency between the team members, they described their team as efficient. The nurses and assistant nurses were involved in the production and discussed working in a timely manner more than the leaders.

Conclusions. The seven ways of understanding operating room efficiency appear to represent both organization-oriented andindividual-oriented understanding of that concept in surgical teams. The patient is in focus and efficiency is understood as maintaining quality of care and measuring benefits of care for the patients.

Place, publisher, year, edition, pages
2011. Vol. 23, no 1, 100-106 p.
Keyword [en]
Leadership, quality management, qualitative methods, general methodology, teamwork, human resources
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-138784DOI: 10.1093/intqhc/mzq063ISI: 000286474000012PubMedID: 21098628OAI: oai:DiVA.org:uu-138784DiVA: diva2:379846
Available from: 2010-12-20 Created: 2010-12-20 Last updated: 2017-12-11Bibliographically approved
In thesis
1. Operating Room Efficiency and Postoperative Recovery after Major Abdominal Surgery: The Surgical Team’s Efficiency and the Early Postoperative Recovery of Patients with Peritoneal Carcinomatosis
Open this publication in new window or tab >>Operating Room Efficiency and Postoperative Recovery after Major Abdominal Surgery: The Surgical Team’s Efficiency and the Early Postoperative Recovery of Patients with Peritoneal Carcinomatosis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In selected patients, surgical treatments such as cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) have enabled curative treatment options for previously incurable diseases, such as peritoneal carcinomatosis (PC). The introduction of resource demanding surgery could affect the work process, efficiency, and productivity within a surgical department and factors influencing patient postoperative recovery processes may have an impact on the efficiency of patient care after major surgery.

The aim of this thesis was to investigate operating room efficiency from the perspective of both staff and leaders’ in two different settings (Papers I and II) and the early postoperative recovery of patients with peritoneal carcinomatosis (Papers III and IV).

Interviews were held with 21 people in a county hospital and 11 members of the PC team in a university hospital, and a phenomenographic approach was used to analysis the data (Papers I and II). The patients’ postoperative recovery and pulmonary adverse events (AE) were determined from data retrieved from the electronic health records of 76 patients (Papers III and IV).

The concept of efficiency was understood in different ways by staff members and their leaders (Paper I). However, when working in a team, the team members had both organisation-oriented and individual-oriented understanding of efficiency at work that focused on the patients and the quality of care (Paper II).

The patients with PC regained gastrointestinal functions and could be mobilised during early postoperative recovery phase, although many patients suffered from psychological disturbances, sleep deprivation, and nausea (Paper III). Postoperative clinical and radiological pulmonary AE were common, but did not affect the early recovery process (Paper IV).

In conclusion, leaders who are aware of the variation in understanding the concept of efficiency are better able to create the same platform for staff members by defining the concept of efficiency within the organisation. In a team organisation, the team members have a wider understanding of the concept of efficiency with more focus on the patients. The factors affecting postoperative recovery and pulmonary AE should be considered when designing individualised patient care plans in order to attain a more efficient recovery.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2011. 79 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 713
Keyword
efficiency, operating room, postoperative recovery, peritoneal carcinomatos, cytoreductive surgery, HIPEC
National Category
Surgery
Identifiers
urn:nbn:se:uu:diva-160045 (URN)978-91-554-8190-2 (ISBN)
Public defence
2011-12-02, Auditorium minus, Museum Gustavianum, Akademigatan 3, 753 10 Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2011-11-11 Created: 2011-10-13 Last updated: 2011-11-23Bibliographically approved

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Arakelian, ErebouniGunningberg, LenaLarsson, Jan

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