Implementation of team training in outpatient breast oncology.

83 Background: Team Training (TT) principles, used in high-risk industries to reduce errors and improve communication and task coordination, have been applied in several areas of medicine, but not in outpatient oncology. We piloted a TT program in a large, academic, clinical breast cancer program. Methods: Observations, interviews, and anonymous adverse event reporting systems were used to identify areas of vulnerability for intervention: Communication of changes in same-day chemotherapy orders (“change orders”); Missing treatment orders on days patients were not also scheduled with physician (“unlinked” visits); Follow-up and communication to other team members on important patient issues (e.g., pending test results or changes in patient status); Conflict resolution between providers and staff. Agreements about roles, responsibilities, and behaviors were made to address vulnerabilities. Using a train-the-trainer model, clinical leaders trained all providers and staff in TT principles, behavioral agreemen...