Evidence map›Paper›PMID 28263939›Full record

Observational studyCirculation. Cardiovascular quality and outcomes2016

Association Between Physician Teamwork and Health System Outcomes After Coronary Artery Bypass Grafting.

John M Hollingsworth, Russell J Funk, Spencer A Garrison, Jason Owen-Smith, Samuel A Kaufman, Francis D Pagani, Brahmajee K Nallamothu

Open access · bronzeAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation. Cardiovascular quality and outcomes, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed
8.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 45 citations in OpenAlex.

  1. Hemodialysis Facilities, Vascular Access Surgeons, and Central Venous Catheter Use: A Retrospective Cohort Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2026
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  10. Infections following left ventricular assist device implantation and 1-year health-related quality of life.The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

John M HollingsworthFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.). kinks@med.umich.edu.
Russell J FunkFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
Spencer A GarrisonFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
Jason Owen-SmithFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
Samuel A KaufmanFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
Francis D PaganiFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
Brahmajee K NallamothuFrom the Department of Urology (J.M.H., S.A.K.), Department of Cardiac Surgery (F.D.P.), Michigan Center for Health Analytics and Medical Prediction (M-CHAMP), Department of Internal Medicine (B.K.N.), University of Michigan Medical School, Ann Arbor; Department of Strategic Management and Entrepreneurship, University of Minnesota Carlson School of Management, Minneapolis (R.J.F.); VA Health Services Research and Development Center for Clinical Management Research, VA Ann Arbor Healthcare System, MI (B.K.N.); and Department of Sociology, College of Literature, Sciences, and the Arts, University of Michigan, Ann Arbor (S.A.G, J.O.-S.).
University of Minnesota · USVA Ann Arbor Healthcare System · USVA Center for Clinical Management Research · US

Funding

Assessing the Effects of Accountable Care Organizations on Surgical Spending and QualityR01HS024525 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM · 2016 to 2020
$1.7M
Will the Reach of ACOs Extend to Specialty Care?R01HS024728 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM · 2016 to 2020
$1.6M
Effects of Physician Social Networks on Surgical Quality, Safety, and CostsK08HS020927 · AHRQ · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLINGSWORTH, JOHN MALCOLM · 2012 to 2015
$614k
AHRQ HHS K08 HS020927AHRQ HHS R01 HS024525AHRQ HHS R01 HS024728
6 · The paper itself

Abstract

backgroundPatients undergoing coronary artery bypass grafting (CABG) must often see multiple providers dispersed across many care locations. To test whether teamwork (assessed with the bipartite clustering coefficient) among these physicians is a determinant of surgical outcomes, we examined national Medicare data from patients undergoing CABG. METHODS AND

resultsAmong Medicare beneficiaries who underwent CABG between 2008 and 2011, we mapped relationships between all physicians who treated them during their surgical episodes, including both surgeons and nonsurgeons. After aggregating across CABG episodes in a year to construct the physician social networks serving each health system, we then assessed the level of physician teamwork in these networks with the bipartite clustering coefficient. Finally, we fit a series of multivariable regression models to evaluate associations between a health system's teamwork level and its 60-day surgical outcomes. We observed substantial variation in the level of teamwork between health systems performing CABG (SD for the bipartite clustering coefficient was 0.09). Although health systems with high and low teamwork levels treated beneficiaries with comparable comorbidity scores, these health systems differed over several sociocultural and healthcare capacity factors (eg, physician staff size and surgical caseload). After controlling for these differences, health systems with higher teamwork levels had significantly lower 60-day rates of emergency department visit, readmission, and mortality.

conclusionsHealth systems with physicians who tend to work together in tightly-knit groups during CABG episodes realize better surgical outcomes. As such, delivery system reforms focused on building teamwork may have positive effects on surgical care.

Indexed as

Coronary Artery BypassAgedCardiologistsCluster AnalysisCooperative BehaviorDelivery of Health Care, IntegratedEmergency Service, HospitalFemaleHealth Services ResearchHumansInterdisciplinary CommunicationMaleMedicareMultivariate AnalysisPatient Care TeamPatient Readmissioncomorbiditycoronary artery bypasshealth services researchMedicaresurgeons

Identifiers

PMID28263939
PMCPMC5746343
OpenAlexW2552630143

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.