A team effort: Cooperation boosts heart surgery outcomes

Researchers at the University of Michigan Medical School have found survival rates of heart surgery patients correlate with the amount of cooperation among the care team through preparation, operation, hospitalization and recuperation processes.

"Surgical care is complex, involving multiple providers dispersed across locations over time," said John Hollingsworth, MD, MS, lead author of the new paper and a University of Michigan urologist. "Our findings show that physician teamwork influences patient outcomes, even more than some measures of comorbid illness."

Analyzing data of 251,000 patients undergoing heart bypass surgery, researchers were able to record the interactions with 466,000 physicians who provided care in order to show the affects of social networks on patient outcomes.

The more often physicians worked with one another in caring for other patients, the lower their current patient's chances of ending up in the emergency department or hospital or dying within two months of the operation.

Results concluded the following:

• A 25 percent increase in teamwork lead to 17 fewer readmissions per 1,000 patients.
• A 25 percent increase in the complexity of patient’s diseases only accounted for one extra readmission per 1,000 patients.
• The teamwork effect remained unchanged by the type of hospital or number of surgeries performed.
• Large academic medical centers had lower rates of teamwork due to less patient being referred to them.

"A lot of the focus in improving care is focused on the acute hospitalization for an episode of care. We believe this focus is too myopic because it ignores the care delivered prior to the hospital stay and after discharge," says Hollingsworth. "Efforts to improve teamwork and outcomes need to consider the entire care continuum."