Implementation of a team training program in the treatment of breast cancer patients.

e16515 Background: Team Training (TT) principles, used in high-risk industries to reduce errors and improve communication and task coordination, have been applied in other areas of medicine, but never in an outpatient subspecialty setting. We piloted a TT program in a large, academic breast cancer program. Methods: Observations, interviews and anonymous adverse event reporting systems were used to identify areas of vulnerability warranting intervention: 1) communication of changes in chemotherapy orders on the day of treatment ("change orders") 2) missing orders on treatment days that patients were not also scheduled to see their physician (“unlinked” visits) 3) follow-up and communication to other team members on important patient issues (e.g. pending test results or changes in patient status) 4) conflict resolution between providers and staff. For each area, agreements about roles, responsibilities and behaviors were made. Using a train-the-trainer model, clinical leaders trained all providers and staff...