Improving team structure and communication: a key to hospital efficiency

Arch Surg. 2004 Nov;139(11):1194-8. doi: 10.1001/archsurg.139.11.1194.


Hypothesis: Improving team structure and heightening communication will help provide cost-effective and high-quality patient care for general surgery patients.

Design: This study surveys teamwork initiatives and their effects on specific variables related to patient care.

Patients: The study population comprised all patients admitted to the hospital's general surgery teams during 5 years 3 months.

Setting: Tertiary care hospital.

Interventions: A complete restructuring of the patient care team for general surgery patients admitted to the hospital. The intervention occurred midway through the study period.

Main outcome measures: Mean length of stay for general surgery patients as a marker of team efficiency and a standardized patient satisfaction survey.

Results: The mean length of stay after initiation of the restructured care team was significantly shorter than before initiation. The significance was present despite a consistent patient acuity measure and was associated with a high patient satisfaction level.

Conclusions: Restructuring the patient care team yielded a decreased mean length of stay while maintaining a high level of patient satisfaction. This analysis helps validate a hospital-wide initiative to maintain a high level of patient care while increasing patient volume.

MeSH terms

  • Cost-Benefit Analysis / organization & administration
  • Efficiency, Organizational*
  • General Surgery / economics
  • General Surgery / organization & administration*
  • Hospitals
  • Humans
  • Interdisciplinary Communication*
  • Length of Stay / economics
  • Patient Care / economics
  • Patient Care / methods
  • Patient Care Team / economics
  • Patient Care Team / organization & administration*
  • Patient Satisfaction
  • Quality of Health Care / economics
  • Quality of Health Care / organization & administration*
  • United States