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Background <p>Team dynamics influence team performance and patient outcomes in surgery, yet data on resident-led teams are scarce. This study aimed to compare patient outcomes across resident-led teams in complex surgical oncology. We hypothesized that patient outcomes would vary by team assignment.</p> Methods <p>This was a retrospective cohort study of resident-led teams who contributed more than 10 surgical oncology operations (colectomy, hepatectomy, pancreatectomy, or thyroidectomy) to the National Surgical Quality Improvement Project registry at a single university-based hospital (2018–2025). The primary outcome was presence of any adverse event, including mortality and postoperative complications. Length of stay and 30-day readmissions were also examined. Mixed-effects regression estimated expected outcome probabilities for each patient. For each team, observed-minus-expected (O-E) outcome rates were calculated to assess performance.</p> Results <p>In total, 145 teams cared for a median of 22 patients (interquartile interval 16– 27; <i>n</i>&#xa0;=&#xa0;2919). Five teams demonstrated poor performance based on risk-adjusted adverse event rates (O-E rates: 6.9% and 22.3%). A total of 13 teams had significantly longer risk-adjusted length of stays than expected (O-E between 0.4 and 3.5 days), and seven teams had shorter risk-adjusted length of stays than expected (O-E between -1.1 and -0.7 days). Three teams had higher risk-adjusted readmission rates than expected (O-E between 4.9% and 6.8%). Two teams performed poorly across all three outcomes.</p> Conclusions <p>Variation in team performance can be measured using valid and reliable risk-adjusted patient outcomes in complex surgical oncology. This may provide meaningful feedback with benchmarking to identify teams that require more supervision.</p>

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Comparing Resident Team Performance in Complex Surgical Oncology: A Single-Institution Cohort Study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月14日

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  • Rachael C. Acker,
  • James E. Sharpe,
  • Shane Williams,
  • Sarah I. Landau,
  • James Rowe,
  • Douglas Fraker,
  • Giorgos C. Karakousis,
  • Heather Wachtel,
  • Rachel R. Kelz

摘要

Background

Team dynamics influence team performance and patient outcomes in surgery, yet data on resident-led teams are scarce. This study aimed to compare patient outcomes across resident-led teams in complex surgical oncology. We hypothesized that patient outcomes would vary by team assignment.

Methods

This was a retrospective cohort study of resident-led teams who contributed more than 10 surgical oncology operations (colectomy, hepatectomy, pancreatectomy, or thyroidectomy) to the National Surgical Quality Improvement Project registry at a single university-based hospital (2018–2025). The primary outcome was presence of any adverse event, including mortality and postoperative complications. Length of stay and 30-day readmissions were also examined. Mixed-effects regression estimated expected outcome probabilities for each patient. For each team, observed-minus-expected (O-E) outcome rates were calculated to assess performance.

Results

In total, 145 teams cared for a median of 22 patients (interquartile interval 16– 27; n = 2919). Five teams demonstrated poor performance based on risk-adjusted adverse event rates (O-E rates: 6.9% and 22.3%). A total of 13 teams had significantly longer risk-adjusted length of stays than expected (O-E between 0.4 and 3.5 days), and seven teams had shorter risk-adjusted length of stays than expected (O-E between -1.1 and -0.7 days). Three teams had higher risk-adjusted readmission rates than expected (O-E between 4.9% and 6.8%). Two teams performed poorly across all three outcomes.

Conclusions

Variation in team performance can be measured using valid and reliable risk-adjusted patient outcomes in complex surgical oncology. This may provide meaningful feedback with benchmarking to identify teams that require more supervision.