Bringing a Multiteam Systems Perspective to the Perioperative Context: Considerations for Future Research of Perioperative Handoffs

Abstract

Background: Perioperative handoffs entail transferring responsibility for surgical patients from one specialized group or team to another. Multiteam system (MTS) theory has not yet been considered within perioperative handoff literature, even though multiple teams must work within and across the preoperative, intraoperative, and postoperative settings to care for shared patients.

Methods: Using a case study from gynecological oncology, the authors demonstrate the applicability of an MTS taxonomy to the perioperative context. Compositional, linkage, and developmental MTS attributes are defined, along with the concept of boundary spanning, using examples from the case study to illustrate their relevance to the perioperative environment. Key research issues invoked through the application of the MTS taxonomy are discussed alongside overarching recommendations regarding approaches and methods to study these issues.

Results: This discussion of perioperative handoffs considers team functional diversity and motivation, between-team interdependence and communication patterns, changes in MTS composition and structure, and boundary spanning. The authors make overarching recommendations for future research that specify mapping perioperative MTSs, identifying weaknesses in MTS functioning and possible handoff design countermeasures, and evaluating handoffs designs' impact on patient care and MTS outcomes using several study designs.

Conclusion: An MTS perspective can uniquely inform key research questions to advance the practice of perioperative handoffs. Processes that affect complex patient safety and care quality outcomes demand consideration of between-team collaboration quality during perioperative periods. The application of MTS theory in intervention research addressing perioperative handoffs can support MTS functioning for the benefit of safe, high-quality care.