Teamwork in Skull Base Surgery: An Avenue for Improvement in Patient Care

Introduction: During the last several decades, leading centers worldwide have acquired significant expertise in the treatment of skull base pathologies. Favorable outcomes are not only due to meticulous surgical planning and execution, they are also in part related to the collaborative efforts of multiple disciplines. We review the impact of teamwork on patient care, elaborate on the key processes for successful teamwork, and discuss its challenges.

Methods: PubMed and Medline databases were searched for publications from 1970 to 2012 using the following keywords: teamwork, multidisciplinary, interdisciplinary, surgery, skull base, neurosurgery, tumor, and outcome. The reference section of each article was reviewed and pertinent articles identified.

Results: A review of the literature testifies to the complexity of establishing and maintaining strong teamwork. To date, few reports on the impact of teamwork in the management of skull base pathologies have been published. This lack of literature on the topic is somewhat surprising given that many if not most patients with skull base pathology receive care from multiple specialists. Common factors for success include a cohesive and well-integrated team structure with well-defined procedural organization. Although a multidisciplinary work force has clear advantages for improving today’s quality of care and propelling research efforts for tomorrow’s cure, teamwork is not intuitive and requires training, guidance, and executive support.

Conclusions: Teamwork is recommended to improve quality over the full cycle of care and consequently patient outcomes. Increased recognition of the value of an integrated team approach for skull base pathologies will hopefully encourage centers, physicians, allied healthcare givers, and scientists devoted to treating these patients and advancing the field of knowledge to invest the time, effort, and resources to optimize and organize their collective expertise.