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Benchmarking is increasingly considered a useful management instrument to improve performance in healthcare. The purpose of this paper is to assess if a nationwide long-term benchmarking collaborative between operating room (OR) departments of university medical centres in the Netherlands leads to benefits in OR management and to evaluate if the initiative meets the requirements of the 4P-model.

The evaluation was based on the 4P-model (purposes, performance indicators, participating organisations, performance management system), developed in former studies. A mixed-methods design was applied, consisting of document study, observations, interviews as well as analysing OR performance data using SPSS statistics.

Collaborative benchmarking has benefits different from mainly performance improvement and identification of performance gaps. It is interesting that, since 2004, the OR benchmarking initiative still endures after already existing for ten years. A key benefit was pointed out by all respondents as “the purpose of networking”, on top of the purposes recognised in the 4P-model. The networking events were found to make it easier for participants to contact and also visit one another. Apparently, such informal contacts were helpful in spreading knowledge, sharing policy documents and initiating improvement. This benchmark largely met all key conditions of the 4P-model.

The current study has the limitations accompanied with any qualitative research and particularly related to interviewing. Qualitative research findings must be viewed within the context of the conducted case study. The experiences in this university hospital context in the Netherlands might not be transferable to other (general) hospital settings or other countries. The number of conducted interviews is restricted; nevertheless, all other data sources are extensive.

A collaborative approach in benchmarking can be effective because participants use its knowledge-sharing infrastructure which enables operational, tactical and strategic learning. Organisational learning is to the advantage of overall OR management. Benchmarking seems a useful instrument in enabling hospitals to learn from each other, to initiate performance improvements and catalyse knowledge-sharing.

The purpose of this paper is to present the effect of the introduction of cross-functional team (CFT)-based organization, rather than, on planning and performance of OR teams.

In total, two surgical departments of the Radboud University Nijmegen Medical Center (RUNMC) in the Netherlands were selected to illustrate the effect on performance. Data were available for a total of seven consecutive years from 2005 until 2012 and consisted of 4,046 OR days for surgical Department A and 1,154 OR days for surgical Department B on which, respectively 8,419 and 5,295 surgical cases were performed. The performance indicator “raw utilization” of the two surgical Departments was presented as box-and-whisker plots per year (2005-2011). The relationship between raw utilization (y) and years (x) was analyzed with linear regression analysis, to observe if performance changed over time.

Based on the linear regression analysis, raw utilization of surgical Department A showed a statistically significant increase since 2006. The variation in raw utilization reduced from IQR 33 percent in 2005 to IQR 8 percent in 2011. Surgical Department B showed that raw utilization increased since 2005. The variation in raw utilization reduced from IQR 21 percent in 2005 to IQR 8 percent in 2011.

Hospitals need to improve their productivity and efficiency in response to higher societal demands and rapidly escalating costs. The RUNMC increased their OR performance significantly by introduction of CFT-based organization in the operative process and abandoning the so called functional silos.

The stepwise reduction of variation – a decrease of IQR during the years – indicates an organizational learning effect. This study demonstrates that introducing CFTs improve OR performance by working together as a team.

The aim of this paper is to describe the factors that contribute to understanding how collaboration improves performance in operating rooms (ORs) after introducing the concept of cross‐functional OR scheduling teams.

The concept was investigated at Radboud University Nijmegen Medical Center (RUNMC) in The Netherlands and used on an innovative path based on socio‐technical systems (STS) principles designed to address non‐routine tasks, variety, interferences and errors related to OR scheduling, with the aim of increasing both staff productivity and patient safety. The effects of implementing preoperative cross‐functional teams in the OR were compared qualitatively. The researcher observed all of the team meetings, available data and documentation, and 13 semi‐structured interviews were performed with team members for collecting additional data.

In the literature, it was found that the theory of socio‐technical systems and the fields of group dynamics and self‐managing teams fit the OR setting. The author applied six elements of these theories (setting common goals, cohesion, openness, single‐loop and double‐loop learning, feedback, and control options) to the aspects found in the study. The qualitative findings revealed that high‐performing teams were able to identify bottlenecks in order to improve continuity of care. The cross‐functional teams used several performance indicators to gain insight into their own performance. Consequently, through collaboration, these teams were able to minimise interference and therefore learn. Cross‐functional teams learned how to address interferences and improve their quality of service through improved collaboration and the improved use of control mechanisms.

This research highlights the importance of team‐based approaches and the need to improve collaboration between healthcare professionals.

The paper confirms the value of implementing the socio‐technical systems theory to improve collaboration between healthcare professionals. This case study is a valuable contribution, as it focuses on team‐based organisation in preparing an OR schedule.

The purpose of this paper is to document everyday practices by which hospitalist physicians negotiate barriers to effective teamwork.

Ethnographic observation with a sample of hospitalists chosen to represent a range of hospital and practice types.

Hospitals rely on effective, interprofessional teamwork but typically do not support it. Hospitalist physicians must bridge the internal boundaries within their hospitals to coordinate their patients’ care, but they face challenges – scattered patients, fragmented information, uncoordinated teams, and unreliable processes – that can impact the timeliness and safety of care. Hospitalists largely rely on personal presence and memory to deal with these challenges. Some invent low-tech supports for teamwork, but these are typically neither tested nor shared with others. Formal support for teamwork, primarily case management rounds, is applied unevenly and may not be respected by all team members.

The findings are drawn from observation over a limited period of time with a small, purposefully chosen sample of physicians and hospitals.

Hospitals must recognize the issues hospitalists and other providers face, evaluate and disseminate supports for teamwork, and make interprofessional teamwork a core feature of hospital design and evaluation.

The authors show the nuances of how hospitalists struggle to practice teamwork in a challenging context, and how the approaches they take (relying on memory and personal presence) do not address, and may actually contribute to, the system-level problems they face.