Анестезия и клинические исследования
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Operating Room Leadership: Who is the One?

Vanni Agnoletti, Giorgio Gambale, Massimiliano Meineri and Alex Macario

Leadership is considered as the process (act) of influencing the activities of an organized group in its efforts towards goal setting and goal achievement. It is not easy to differentiate management and leadership. Leadership is concerned with setting a direction for change, developing a vision for the future while management consists of implementing those goals through planning, budgeting and staffing. Cost-restrains and quality improvement mandates operating room to seek dedicated professional perioperative leaders. The anesthesiologists are deeply involved in the successful and efficient operations of the surgical services. In more and more facilities, the anesthesiologist is the recognized authority for “leading” the Operating Room (OR) suite. In contrast, the surgeon may have an incomplete vision of the Operating Room and could be influenced in his/her judgment or action by the conflict between the interest of increasing his/her own (or his/her group) surgical activity and the management responsibility to consider the entire needs and resources of the surgical suite. Another crucial element of the OR team is the nurse. Similar to the anesthesiologist the nurse manager may have the same vision of the OR management. Nurses do have experience in OR leadership and management. Nurses often represent the leadership of the OR suite. It is likely that for many surgical centers the best way to manage an OR suite would be not to have a single leader but a team of anesthesiologists, nurses and surgeons that work as one unit tackling the challenges. Nowadays the importance of leadership on public services is often asserted but the evidence of positive impact on patient safety and quality improvement is weak. More studies are needed to define the optimal leadership structure in surgical suites.