Sustained improvement in intraoperative efficiency following implementation of a dedicated surgical team for pediatric spine fusion surgery

Objective Determine if dedicated surgical teams can improve and sustain intraoperative efficiency for pediatric posterior spine fusion (PSF) Design Comparison of OR efficiency data from sequential summer improvement projects and outcome data following adoption of a dedicated surgical team model for PSF cases. Setting Academic tertiary pediatric hospital Participants Patients undergoing PSF for adolescent idiopathic scoliosis, anesthesiology team, orthopedic surgeons, operating room nurses, neurophysiologists, radiology technicians, preoperative nurses, improvement advisors. Intervention(s) Dedicated surgical team care model for PSF developed using formal quality improvement methodology. Main outcome measure(s) Total operating room time for PSF surgery. Results A multidisciplinary quality improvement team developed and implemented a dedicated team model leading to a 29% reduction in total operating room time in summer 2015 pilot data compared to data collected during a less structured improvement effort in summer 2014. This dedicated team model was expanded to more complicated patients and another high-volume surgeon in January 2016 with consistent improvement in operative efficiency from a historical average of 395 min to 317 min following implementation of the dedicated team model. Conclusions Multidisciplinary efforts are useful for creating dedicated teams and sustainable reductions in total OR time for pediatric PSF.