1. Introduction

Hospital context has undergone multiple changes in the last decade economical field (expenditure growth of hospital logistics), technological field (integration of new technologies), and social field. In this context, hospital systems aimed to reduce expenditure while ensuring greater quality of care. Adverse events related to care affect 3.7–16.6% of patients care in the OECD countries. The incidence in France is 5.1% which represents an average of 6.6% of the adverse events for 1000 hospital days [1]. Also, around half of events occurs during surgical intervention [2, 3], which represents the emblematic of this component.

Investigations focus on complications in the operating rooms date from the 1980s. It is thus crucial to understand causes of complications. Several studies draw our attention for research on the causes of surgical complications. Atul et al. [4] have shown in their study about three hospitals that two-third of complications produced during operative phase. Three factors were cited as factors that contribute to error: the lack of experience/lack of competence for


coordination the efforts made by everyone, that is, teamwork. Selection teams ensure

Successful building and selection teams are still an open problem in various fields of social, business, and hospital studies. To solve this problem, several methods were proposed such as AHP [10, 11], fuzzy-genetic algorithm [12], multiobjective optimization [13], fuzzy logic (Shipley et al., 2013), etc. The main objective of this chapter is to propose a systematic evaluation model to help the decision maker for the building and selection of an optimal team among a set of available alternatives. For building team, we present a new algorithm applied to multidisciplinary team. Then, for selection team, we envelop

that the right team is in place and that it will have a capable leader in place.

An Integrated Approach for the Building and the Selection of Multidisciplinary Teams…

a methodology where we combine a multicriterion decision method and a

The remainder of this chapter is organized as follows: In Section 3, proposed model for weapon building and selection team is presented and the stages of the proposed approach are explained in detail. In Section 4, experimental results and data analysis are discussed. Finally, conclusions of this study are made in Section 5.

Proposed model is divided in two main parts: approach support for building multidisciplinary teams and approach for selection teams, presented in Figure 1. These two approaches can be applied successively or separately, depending on

cognitive method.

3. The model description

DOI: http://dx.doi.org/10.5772/intechopen.80934

the case of application.

Figure 1.

79

Model support for building and selection teams.

#### Table 1.

The causes of complication in the operating room.

surgical task was associated to 53% of incidents, communication problem (43%), fatigue or excessive working (33%). Fleming et al. [5] analyzed interpersonal skills for each members of cardiac surgery team to determine their attitudes regarding team work. Researchers have identified different factors as seniority in grade and adherence in professional community. Respondents reported that erroneous communication, execution of intervention at the wrong time and the not following of procedures that constitute the most frequent types of errors. Statistics of JCAHO show that 65% of severe events (for example, compresses forgotten, error in blood transfusion, etc.) are related to a lack of communication [6].

The results of the analysis of National Surgical Quality Improvement Program (NSQIP) identified the major problems like communication team, lack of skilled care during the patient postoperative care. It is important to note that problems are related to systems and not to individual performance of surgeon [7].

We often classify in the table below different studies depending on the causes identified.

Improvement of techniques and processes in the operating theater does not completely solve complications occurring. Refer to the studies mentioned (Table 1), we can conclude that team building constitutes an obvious starting point.

### 2. Domain and motivation

Operating theater is a containment with high concentration of human competence. An operation needs intervention of different actors from different disciplines (surgeons, anesthetists, nurses, etc.) with various levels of skills. Surgical team performance emerges as key points to ensure the best quality care and risk management. The operating theater is also a deep human place where the individual works on an individual and with an individual. These individuals have personalities, logic, interests, and specific different viewpoints and sometimes conflicting. They constitute a surgical team in which performance and outcomes depend on the degree of

An Integrated Approach for the Building and the Selection of Multidisciplinary Teams… DOI: http://dx.doi.org/10.5772/intechopen.80934

coordination the efforts made by everyone, that is, teamwork. Selection teams ensure that the right team is in place and that it will have a capable leader in place.

Successful building and selection teams are still an open problem in various fields of social, business, and hospital studies. To solve this problem, several methods were proposed such as AHP [10, 11], fuzzy-genetic algorithm [12], multiobjective optimization [13], fuzzy logic (Shipley et al., 2013), etc.

The main objective of this chapter is to propose a systematic evaluation model to help the decision maker for the building and selection of an optimal team among a set of available alternatives. For building team, we present a new algorithm applied to multidisciplinary team. Then, for selection team, we envelop a methodology where we combine a multicriterion decision method and a cognitive method.

The remainder of this chapter is organized as follows: In Section 3, proposed model for weapon building and selection team is presented and the stages of the proposed approach are explained in detail. In Section 4, experimental results and data analysis are discussed. Finally, conclusions of this study are made in Section 5.

#### 3. The model description

surgical task was associated to 53% of incidents, communication problem (43%), fatigue or excessive working (33%). Fleming et al. [5] analyzed interpersonal skills for each members of cardiac surgery team to determine their attitudes regarding team work. Researchers have identified different factors as seniority in grade and adherence in professional community. Respondents reported that erroneous communication, execution of intervention at the wrong time and the not following of procedures that constitute the most frequent types of errors. Statistics of JCAHO show that 65% of severe events (for example, compresses forgotten, error in blood transfusion, etc.) are related to a lack

Studies The causes

\*

\*

Watson et al. [8] \* \*

Wong et al. (2009) \* \*

The causes of complication in the operating room.

Communication Leadership Technical

Taylor et al. [9] \* \* \*

Atul et al. [4] \* \* \*

skills

\*

Fatigue/excessive workload

Collaboration

The results of the analysis of National Surgical Quality Improvement Program (NSQIP) identified the major problems like communication team, lack of skilled care during the patient postoperative care. It is important to note that problems are

We often classify in the table below different studies depending on the causes

Improvement of techniques and processes in the operating theater does not

Operating theater is a containment with high concentration of human competence. An operation needs intervention of different actors from different disciplines (surgeons, anesthetists, nurses, etc.) with various levels of skills. Surgical team performance emerges as key points to ensure the best quality care and risk management. The operating theater is also a deep human place where the individual works on an individual and with an individual. These individuals have personalities, logic, interests, and specific different viewpoints and sometimes conflicting. They constitute a

completely solve complications occurring. Refer to the studies mentioned (Table 1), we can conclude that team building constitutes an obvious starting

surgical team in which performance and outcomes depend on the degree of

related to systems and not to individual performance of surgeon [7].

of communication [6].

Helmreich and Schafer (1994)

Industrial Engineering

Fuchshuber et al.

Doppia et al. (2011)

[7]

Table 1.

JCSES [6] \*

Haller et al. (2011) \*

2. Domain and motivation

identified.

point.

78

Proposed model is divided in two main parts: approach support for building multidisciplinary teams and approach for selection teams, presented in Figure 1.

These two approaches can be applied successively or separately, depending on the case of application.

Figure 1. Model support for building and selection teams.
