title: A standardized operative team for major head and neck cancer ablation and reconstruction.
abstract: BACKGROUND
  Prolonged procedure time in head and neck cancer ablation and free flap reconstruction cases has been shown to significantly increase perioperative complications. The authors' objective was to evaluate the effectiveness of a standardized surgical nursing team for head and neck cancer ablation and free flap reconstruction operations for reducing procedure time.
  
  
  METHODS
  A retrospective cohort analysis of consecutive patients presenting for head and neck cancer ablation and free flap reconstruction between January 1, 2007, and September 1, 2010, was performed. A standardized head and neck surgical nursing team was introduced on May 1, 2009, at our center. Procedure time and case time were measured before and after the introduction of the team. Univariable analyses were performed to evaluate the difference in procedure and case time between the two cohorts. A multivariable linear regression model was developed to control for confounding variables.
  
  
  RESULTS
  There were 52 cases before the team was introduced and 49 cases after. Mean procedure time was reduced by 47.1 minutes (p = 0.04) and mean case time was reduced by 68.9 minutes (p = 0.01) after team introduction. The multivariable linear regression analysis demonstrated a significant reduction in operative time after team introduction, controlling for confounding variables.
  
  
  CONCLUSIONS
  The introduction of a standardized surgical nursing team led to a significant reduction in procedure and case time. A standardized team approach improves operating room efficiency in complex cases such as free flap reconstruction following tumor ablation.
  
  
  METHODS
  Therapeutic, III.
authors: Calgary, Alberta, Canada; and Boston, Mass. From the Sections of Plastic Surgery and Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Calgary, and the Harvard School of Public Health, Harvard University.
authors: Christopher
authors: C
authors: Doherty
authors: Steven C
authors: SC
authors: Nakoneshny
authors: Allan R
authors: AR
authors: Harrop
authors: T Wayne
authors: TW
authors: Matthews
authors: Christiaan
authors: C
authors: Schrag
authors: David C
authors: DC
authors: McKenzie
authors: William
authors: W
authors: De Haas
authors: Roger B
authors: RB
authors: Davis
authors: Joseph C
authors: JC
authors: Dort
mesh_terms: D017115:Catheter Ablation / Q000379:methods / Q000592:standards*; D005260:Female; D005500:Follow-Up Studies; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D010820:Physicians / Q000592:standards*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control*; D019651:Plastic Surgery Procedures / Q000379:methods / Q000592:standards*; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D000078329:Workforce