Bridging Two Worlds: Application of Organizational Theory to Cardiac Surgery.

Background: This review summarizes applications of organizational theory and management research to cardiac surgery as it relates to patient outcomes and the adoption of new technology.

Methods: Included were 17 papers published in top organizational theory and management journals from 2000 to 2020 that examined the cardiac surgery care setting. Findings were classified according to 2 major outcomes of interest: patient care and new technology adoption patterns. Findings were further stratified based on whether predictors of these outcomes were individual-, team-, or organizational-level factors.

Results: A growing number of studies in the organizational theory and management literature have been using the cardiovascular care setting as a research context. Applying the various theoretical lenses of organizational theory, these studies have studied how individual-, team-, and organizational-level factors influence (1) patient care outcomes, such as patient mortality rates, readmission rates, postsurgery complication rates, surgery duration, and length of stay, and (2) the adoption of new technologies or the abandonment of old technologies. Examples of these factors include task specialization, multisiting, attribution, team familiarity dispersion, distribution of failure, workload, responsibility complementarity, expertise, team learning processes, technology status, organizational missions, and organizational status.

Conclusions: Well-established and studied principles from the fields of organizational theory and management research can provide unique and valuable insights into how care processes, individual attributes, systems-related factors, and the interplay between such factors affect cardiac surgical patient outcomes and clinical care. Expanding collaboration between these fields and clinicians in cardiac surgery seems prudent.