Stability of Surgical Teams and Risk of Percutaneous Blood and Body Fluid Exposures

Background and Objectives.  We investigated whether the stability of membership on surgical teams affects the risk of percutaneous blood and body fluid exposures during surgical procedures. 

Methods.  A dynamic cohort of surgical teams working in a single large academic medical institution was compiled.  Approximately 333,000 procedures were amassed and 2,113 events were recorded over the ten-year study period.  An index of “past collaboration” developed by social network analysts was used to quantify the extent to which the surgical teams had worked together in the six months prior to each surgical procedure.  The measure, a property of the team performing the procedure, is standardized ranging from 0 to 1.  Poisson regression was used to model the outcomes while controlling for a variety of characteristics and accounting for the duration of the surgical procedures. 

Results.  Controlling for a host of confounding factors, results suggest a modest protective effect of past collaboration for percutaneous injuries (RR = 0.92, 95% CI [0.88, 0.98] for a one standard deviation increase in the past collaboration index).  Results were slightly stronger for events involving instruments other than suture needles; the association with suture needles was protective but non-significant.  Results also varied among the three settings in the hospital suggesting the work context may contain important moderators that affect the safety benefits of team stability. 

Conclusions.  Greater team stability may improve safety among surgical team members for certain types of percutaneous events and under certain circumstances.  Results may have significance pertaining to patient safety as well.