Bridging Two Worlds: Application of Organizational Theory to Cardiac Surgery

2021 
Abstract Background This review summarizes applications of organizational theory and management research to cardiac surgery as it relates to patient outcomes and the adoption of new technology. Methods A total of 17 papers published in top organizational theory and management journals from 2000-2020 that examined the cardiac surgery care setting were included. Findings were classified according to two major outcomes of interest: patient care and new technology adoption patterns. Findings were further stratified based on whether predictors of these outcomes were individual-, team-, or organizational-level factors. Results A growing number of studies in the organizational theory and management literature has been using the cardiovascular care setting as a research context. Applying the various theoretical lens of organizational theory, these studies have studied how individual-, team-, and organizational-level factors influence 1) patient care outcomes such as patient mortality rates, readmission rates, post-surgery complication rates, surgery duration, and length-of-stay and 2) the adoption of new technologies or the abandonment of old technologies. Examples of these factors include task specialization, multi-siting, attribution, team familiarity dispersion, distribution of failure, workload, responsibility complementarity, expertise, team learning processes, technology status, organizational missions, and organizational status. Conclusions Well-established and studied principles from the fields of organizational theory and management research can provide unique and valuable insights into how care processes, individual attributes, systems-related factors, and the interplay between such factors affect cardiac surgical patient outcomes and clinical care. Expanding collaboration between these fields and clinicians in cardiac surgery seems prudent.
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