Renal, bladder and prostate cancer surgery outcomes with respect to team familiarity.

Abstract

OBJECTIVES To investigate outcomes in urological oncology according to team membership and familiarity. SUBJECTS/PATIENTS We assessed peri-operative times, lengths of stay and re-admission rates in all patients undergoing surgery for prostate, bladder and kidney cancer at Sheffield Teaching Hospitals from 2021 to September 2024. Our analysis was performed with respect to staff pairs and a validated familiarity score (FS) derived using seven team members. RESULTS In total, 1043 patients, 319 staff members and 3791 staff combinations were included. The mean (sd) FS for all cases was 14.2 (7.2), and was 13.7 (7.3), 9.3 (4.1) and 16.7 (7.1) for renal, bladder and prostate surgeries (anova, P < 0.001), respectively. Teams with higher familiarity had shorter times for all peri-operative intervals (anova, P < 0.041), shorter lengths of stay (1.94 vs 5.3 days; anova, P < 0.001) and fewer readmissions within 30 days (4.1% vs 8.0%; chi-squared test, P = 0.01). Greater familiarity led to savings of 26.2, 44.2 and 12.8 min for renal, bladder and prostate surgeries, respectively. In multiple regression, using preoperative features, greater familiarity was associated with fewer total case min (each 1-unit increase in FS equated to -1.88 min; 95% confidence interval -2.25 to -1.29; P < 0.001). Regarding team dyads, the greatest difference in total case duration was for the Surgeon #1/Surgeon #2 combination (average 40.8-min saving). Increased anaesthetic familiarity (with anaesthetic assistant) was associated with shorter anaesthetic room durations (anova, P = 0.007) and shorter delays leaving theatre (P < 0.001). CONCLUSION Greater team familiarity was associated with faster surgical times and shorter lengths of stay. The time savings could be used to improve theatre usage and efficiency.