Surgical Team Effectiveness Model: Team Awareness mediates subculture teamwork and communications

Abstract

The Institute of Medicine (Kohn et al, 2000) reports that effective team function is a core principle of safe health care systems. Lemieux-Charles and McGuire (2006)’s Integrated Team Effectiveness Model (ITEM) provides a comprehensive and adaptable framework for describing healthcare team effectiveness. Here we adapt the ITEM within the microenvironment of surgical team design based on the ad hoc nature of a Standard Roles Variable Personnel construct (Andreatta, 2010). With the changing nature of personnel, we propose that team monitoring requires a degree of constant awareness to changes in membership and task prioritization throughout the course of a surgery. We propose the concept of Team Awareness, the negotiation of Standard Roles Variable Personnel at the level of the individual as a mediator between teamwork and organizational outcomes. The implications of Team Awareness are necessary for understanding how individuals balance between competing priorities in team subcultures. Describing a group-level context for surgery offers the opportunity to shift agency towards individuals' role in effectiveness. The result is a Surgical Team Effectiveness Model, an understanding of the relationships between teamwork and organizational outcomes in surgery. This model may be valuable for soliciting organizational and team member support for improving teamwork in the operating room.