title: Characterizing the structure of operating room staffing using social network analysis.
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.
  
  
  OBJECTIVE
  : 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.
  
  
  CONCLUSIONS
  : 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.
authors: School of Nursing, University of Michigan, Ann Arbor, USA. fauve@umich.edu
authors: Christine
authors: C
authors: Anderson
authors: Akkeneel
authors: A
authors: Talsma
mesh_terms: D017598:Efficiency, Organizational; D013502:General Surgery / Q000458:organization & administration*; D006801:Humans; D007400:Interprofessional Relations; D007857:Leadership; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D015146:Midwestern United States; D009493:Neurosurgery / Q000458:organization & administration*; D009873:Operating Rooms / Q000458:organization & administration*; D010348:Patient Care Team / Q000458:organization & administration; D010379:Peer Group; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D000078329:Workforce