Display options
Share it on

Surg Neurol Int. 2013 Mar 25;4:36. doi: 10.4103/2152-7806.109527. Print 2013.

Teamwork in skull base surgery: An avenue for improvement in patient care.

Surgical neurology international

Nancy McLaughlin, Ricardo L Carrau, Daniel F Kelly, Daniel M Prevedello, Amin B Kassam

Affiliations

  1. Department of Neurosurgery, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Suite 6236, Los Angeles, CA, 90095-7436, USA.

PMID: 23607058 PMCID: PMC3622378 DOI: 10.4103/2152-7806.109527

Abstract

BACKGROUND: During the past several decades, numerous centers have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, but they are also related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges.

METHODS: Pubmed and Medline databases were searched for publications from 1970 to 2012 using the following keywords: "teamwork", "multidisciplinary", "interdisciplinary", "surgery", "skull base", "neurosurgery", "tumor", and "outcome".

RESULTS: Current literature testifies to the complexity of establishing and maintaining teamwork. To date, few reports on the impact of teamwork in the management of skull base pathologies have been published. This lack of literature is somewhat surprising given that most patients with skull base pathology receive care from multiple specialists. Common factors for success include a cohesive and well-integrated team structure with well-defined procedural organization. Although a multidisciplinary work force has clear advantages for improving today's quality of care and propelling research efforts for tomorrow's cure, teamwork is not intuitive and requires training, guidance, and executive support.

CONCLUSIONS: Teamwork is recommended to improve quality over the full cycle of care and consequently patient outcomes. Increased recognition of the value of an integrated team approach for skull base pathologies will hopefully encourage centers, physicians, allied health caregivers, and scientists devoted to treating these patients and advancing the field of knowledge to invest the time, effort, and resources to optimize and organize their collective expertise.

Keywords: Multidisciplinary; neurosurgery; outcome; skull base; teamwork

References

  1. J Neurosurg. 2011 Jun;114(6):1544-68 - PubMed
  2. Curr Opin Otolaryngol Head Neck Surg. 2008 Apr;16(2):103-7 - PubMed
  3. Otolaryngol Head Neck Surg. 2010 Nov;143(5):650-4 - PubMed
  4. Eur J Oncol Nurs. 2002 Sep;6(3):148-54 - PubMed
  5. Dis Esophagus. 2006;19(3):164-71 - PubMed
  6. J Contin Educ Health Prof. 2008 Fall;28(4):228-34 - PubMed
  7. Clin Neurosurg. 1999;45:86-100 - PubMed
  8. CA Cancer J Clin. 2009 May-Jun;59(3):192-211 - PubMed
  9. BJOG. 2012 Jan;119(2):160-5 - PubMed
  10. Curr Opin Otolaryngol Head Neck Surg. 2003 Aug;11(4):282-90 - PubMed
  11. Neurosurgery. 2012 Nov;71(5):916-24; discussion 924-6 - PubMed
  12. Surg Neurol. 2003 Feb;59(2):139 - PubMed
  13. Br J Neurosurg. 2005 Apr;19(2):122-7 - PubMed
  14. Neurosurgery. 2006 Oct;59(4 Suppl 2):ONS212-20; discussion ONS220 - PubMed
  15. JAMA. 2007 Mar 14;297(10):1103-11 - PubMed
  16. J Neurosurg Pediatr. 2011 Jul;8(1):22-9 - PubMed
  17. Laryngoscope. 2007 Apr;117(4):699-705 - PubMed
  18. Eur J Surg Oncol. 2007 Apr;33(3):307-13 - PubMed
  19. Laryngoscope. 2011 Oct;121(10):2131-5 - PubMed
  20. Eye (Lond). 2011 Oct;25(10):1360-4 - PubMed
  21. Ann Ist Super Sanita. 2011;47(1):64-71 - PubMed
  22. Am J Surg. 2005 Nov;190(5):770-4 - PubMed
  23. Onkologie. 2005 Jan;28(1):22-6 - PubMed
  24. Clin Med (Lond). 2012 Feb;12(1):14-8 - PubMed
  25. Arch Otolaryngol Head Neck Surg. 2000 Mar;126(3):322-6 - PubMed
  26. Ann Oncol. 2008 Feb;19(2):284-91 - PubMed
  27. J Prof Nurs. 2008 Jul-Aug;24(4):218-27 - PubMed
  28. Surg Neurol. 2006 Jun;65(6):635-6 - PubMed
  29. J Interprof Care. 2001 Feb;15(1):29-35 - PubMed
  30. Neurosurgery. 2007 Nov;61(5 Suppl 2):202-9; discussion 209-11 - PubMed
  31. Int J Nurs Stud. 2008 Jan;45(1):140-53 - PubMed
  32. BMJ. 2012 Apr 26;344:e2718 - PubMed
  33. J Interprof Care. 2001 May;15(2):141-51 - PubMed
  34. Eur Arch Otorhinolaryngol. 2010 May;267(5):647 - PubMed
  35. Contemp Nurse. 2005 Sep;20(1):28-37 - PubMed
  36. Surgery. 2011 Oct;150(4):771-8 - PubMed
  37. Clin Invest Med. 2006 Dec;29(6):351-64 - PubMed
  38. J Neurol Neurosurg Psychiatry. 2000 Aug;69(2):161-6 - PubMed
  39. Neurosurgery. 2008 Mar;62(3):539-55; discussion 539-55 - PubMed
  40. J Healthc Manag. 2010 Nov-Dec;55(6):399-411; discussion 411-2 - PubMed
  41. N Engl J Med. 2010 Dec 23;363(26):2477-81 - PubMed
  42. J Neurosurg. 2006 Jan;104(1):137-42 - PubMed
  43. Br J Cancer. 2011 Apr 12;104(8):1246-8 - PubMed
  44. Am J Rhinol Allergy. 2009 Sep-Oct;23(5):518-21 - PubMed
  45. Curr Opin Endocrinol Diabetes Obes. 2010 Aug;17(4):369-76 - PubMed
  46. J Natl Cancer Inst Monogr. 2010;2010(40):72-80 - PubMed

Publication Types