As companies in all industries adopt new technologies to assist teams, they should keep in mind that the experiences of the team’s members working with each other in the past still matter a lot.

A study of surgeries at a mid-sized hospital in Madrid, Spain, reinforced that point and generated other insights into how best to staff teams.

Hospitals have spent years investing in digital tools—dashboards, predictive algorithms, and real-time monitoring systems—to optimize their operating rooms.

However, inefficiency persists, duration variability remains high, and performance often differs dramatically from one day to the next or from one team to the next.

Our research, based on more than 77,000 surgeries conducted from 2016 to 2019 at HLA Moncloa Hospital, an urban general teaching hospital in Madrid, found that a substantial driver of operating room performance is not technology.