Characterizing the structure of operating room staffing using social network analysis

Nurs Res. 2011 Nov-Dec;60(6):378-85. doi: 10.1097/NNR.0b013e3182337d97.

Abstract

Background: : Very little research has been focused on the interdisciplinary staffing characteristics of the operating room team, an essential component of providing safe patient care in a high-risk setting.

Objectives: : The aim of this study was to determine how the operating room staffing of two surgical specialties compares in terms of social network variables.

Methods: : Staffing data from all general and neurosurgical procedures performed at a large Midwestern hospital were analyzed using Social Network Analysis methods. Network variables include centrality, team coreness, and the core/periphery network structure. Multidimensional scaling, correlation, and descriptive statistics were used for the analysis.

Results: : The core/periphery network structure was characteristic of both surgical services. Team coreness, a measure of how often the team worked together, was associated with the length of the case (p < .001). Procedure start time predicts the team coreness measure, with cases starting later in the day less likely to be staffed with a high core team (p < .001). Registered nurses constitute the majority of core interdisciplinary team members in both groups.

Discussion: : Analysis of the core/periphery structure of specialty team staffing networks indicates that many procedures are staffed with individuals who are associated peripherally with the specialty. Registered nurses as core group members are in a position to take a leadership role in the communication of norms and process variations to noncore members. The effect of having late starting cases staffed with a lower core team should be studied further because it pertains to patient outcomes. Future work should strive to account for the complex and dynamic nature of team development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Efficiency, Organizational
  • General Surgery / organization & administration*
  • Humans
  • Interprofessional Relations*
  • Leadership
  • Medical Staff, Hospital / organization & administration*
  • Midwestern United States
  • Neurosurgery / organization & administration*
  • Operating Rooms / organization & administration*
  • Patient Care Team / organization & administration
  • Peer Group
  • Personnel Staffing and Scheduling / organization & administration*
  • Workforce