Project 461618

Heart surgery is a complex and commonly performed procedure used to treat patients with critical disease. It is life altering in that patients may have restoration of quality and quantity of life or develop adverse complications that include death. Although much research has evaluated patient comorbidities and surgical technique as primary drivers for patient outcomes, few data have studied the influence of team dynamics as they pertain to patient care. Communication and team dynamics are known to influence complex work environments in the finance, military, and aviation industries. Women and men have been shown to function in team structures differently, as do people with varying sociodemographic characteristics such as sex, gender, age, cultural background, and experience. Heart surgery is performed in an interprofessional team composed of surgeons, anesthesiologists, nurses, as well as specialists that manage the heart-lung machine. Evidence shows that teamwork and communication is critical in preventing adverse patient outcomes, especially in the setting of cardiac surgery given the long duration and high acuity of these operations. Team dynamics and patient outcomes may be influenced by sociodemographic characteristics of healthcare providers and patients, but the influence of these factors on patient care has not yet been assessed in the cardiac operating room. In this proposal, we will assess the impact of physician and patient factors on patient outcomes after cardiac surgery using high quality population-based data in Canada. We will then explore the potential mechanisms for our observations along with their implications for teamwork and patient-provider interactions through focus group interviews. The primary outcome of this study is all-cause mortality in the first 30 days after surgery. Findings from this study will inform future teamwork interventions to improve surgical success and the quality of teamwork in the cardiac operating room.