Staffing turnover effect of fellowship-trained surgical specialists on oncologic outcomes in community cancer center.

187Background: Contemporary health care is delivered in highly interdependent team-based environment. Transitions in surgeon complement may be associated with a disturbance of workflow, especially in smaller-sized community cancer centers. Herein we examined the impact of two surgical oncologists turnover in our cancer center. Methods: Survival outcomes of all cases of esophageal, gastric, rectal and pancreatic adenocarcinoma treated in the index cancer center (n = 1,445) were compared to then-contemporary standard derived from Iowa-SEER registry, 2001-2015 (n = 12,617). Period before and after changeover of surgeons was compared using descriptive statistics and regression model. Results: Substantial reduction of annually referred (101.8±9.2 versus 60.5±0.7 case per year, p = 0.026) and operative cases (37.0±4.5 versus 17.5±3.5 cases per year, p = 0.027) was seen during fully-staffed versus on-boarding periods at the index hospital. At the state level, there was no fluctuation of annually referred cases (...