title: Team training can improve operating room performance.
abstract: BACKGROUND
  This study was conducted to determine if team training using a federally sponsored team training program improves operating room (OR) performance and culture.
  
  
  METHODS
  The TeamSTEPPS program, a team training program designed and tested for health care applications, was provided to the OR staff. The training occurred over 2 months to all members of the OR team, including scrub technicians, nurses, certified registered nurse anesthetists, anesthesiologists, surgeons, and all anesthesiology and surgical resident staff.
  
  
  RESULTS
  After 9 months, there was a significant improvement in the OR staff team work (score 53.2 to 62.7; P < .05) and OR communications (score 47. 5 to 62.7; P < .05). There was significant improvement in OR first case starts (69% to 81%), Surgical Quality Improvement Program measures (antibiotic administration, 78% to 97% [P < .05]; venous thromboembolism administration, 74% to 91% [P < .05]; and beta blocker administration, 19.7% to 100%; P < .05) and patient satisfaction (willingness to recommend, 77% to 89.3% [P < .05]). NSQIP measured overall surgical morbidity and mortality, which were both significantly improved (mortality, 2.7% to 1% [P < .05]; morbidity, 20.2% to 11.0% [P < .05]), indicating a significant change in the overall OR culture. A year later, the data showed that factors linked to regulatory requirements, such as Surgical Quality Improvement Program measures linked to the time out remained improved while first case on time starts decreased (81% to 69%; P < .05), patient willingness to recommend decreased (89.3% to 80.8%; P < .05), surgical mortality increased (1% to 1.5%; P < .05), and surgical morbidity increased (11% to 13%; P < .05) reflecting a degree of culture deterioration which has persisted.
  
  
  CONCLUSIONS
  These data confirm that team training improves OR performance, but continued team training is required to provide sustained improved OR culture.
authors: Department of Surgery, School of Medicine, Creighton University, Omaha, NE 68131, USA. armour.forse@creighton.edu
authors: R
authors: R
authors: Armour Forse
authors: J D
authors: JD
authors: Bramble
authors: Robert
authors: R
authors: McQuillan
mesh_terms: D000046:Academic Medical Centers; D003142:Communication; D013502:General Surgery / Q000193:education* / Q000592:standards; D006801:Humans; D007318:Inservice Training / Q000379:methods* / Q000592:standards; D007400:Interprofessional Relations; D009329:Nebraska; D009873:Operating Rooms; D010348:Patient Care Team / Q000592:standards; D015397:Program Evaluation; D011785:Quality Assurance, Health Care; D011795:Surveys and Questionnaires