Lack of teamwork, cooperation among UK surgeons are putting patients at risk
Yesterday, Royal College of Surgeons (RCS) urged surgical teams and leaders to improve their attitudes after a study published in the BMJ revealed “poor team working between surgeons is often a major factor” when surgical problems occur.
The RCS looked at 100 hundred surgical reviews over 10 years and discovered as many as 76 percent of the reviews revealed poor teamwork as a factor that led to problems in surgical practice and more than two thirds of the RCS reviews indicated timely recognition and resolution of concerns to be an issue. They found that most surgeons were not meeting regularly or effectively as a consultant surgical team.
The RCS said, in a press statement, that according to the most recent Care Quality Commission Annual State of Care report most hospital surgeries are rated good or outstanding but there are a small number of surgical departments that need attention and training to improve surgical outcomes and the standards of patient care provided by the NHS.
The RCS analyzed a sequential sample of 100 of its reviews - 58 service reviews, 25 individual surgeon reviews, and 17 clinical record reviews - out of a total of 240 conducted between 2008 and the end of 2017, to identify lessons about how problems occur and where improvements need to be made.
“In all but a handful of reviews, team-working was an issue,” said Professor Timothy Rockall, Chair of the RCS Invited Review Mechanism. “This was an issue because, for example, consultants were not meeting regularly to reflect on practice, or where tensions between group members form after mergers with other teams or organizational restructuring.”
Surgical care delivery issues were a significant factor in four out of five reviews (82%), however these were multidimensional and unique to each review. For example, the training undertaken by a surgeon before embarking on independent practice or adopting a new technique, the preoperative assessment offered to patients, and the quality of immediate postoperative care.
In his statement, Rockall said questioning a surgeon’s performance isn’t easy to do but critical nonetheless and should be done more frequently to resolve problems before they affect the safety of patients. “It is also worth emphasizing that problems with team-working are not unique to surgery and hospitals should be considering how improvements in team-working can be made across all services.”
