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Original Article
November 1, 2004

Improving Team Structure and Communication: A Key to Hospital Efficiency

Author Affiliations

Author Affiliations: Department of Surgery and Clinical Performance Management Team, Massachusetts General Hospital, Boston.

Arch Surg. 2004;139(11):1194-1198. 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 hospitalwide initiative to maintain a high level of patient care while increasing patient volume.