The aim of this pilot study was to identify if establishing a reliable framework for consistent use of TeamSTEPPS communication would improve the team communication and performance during the critical handoff of the cardiac surgical patient from the OR team to the ICU team. Breakdown in handoff communication has been attributed as the cause of adverse health events, delays in treatment, inappropriate treatment, increased length of stay, and increased costs and inefficiencies from rework. Standardizing handoff communication is a Joint Commission National Patient Safety Goal, and immediate postoperative cardiac surgical patients are a high-risk population needing consistently high quality communication at handoff. After education was done on TeamSTEPPS communication, in situ simulation was the method used to observe the cardiovascular surgical team's handoff of care to the ICU team. Despite an improvement from pre- to post-simulation, a statistically significant difference was not shown in the teams' perception of communication and performance. Skills necessary for team members to contribute to highly reliable, interdisciplinary teams can be attained through high-fidelity in situ simulation to ensure patient safety, but individual attitudes and behaviors can adversely affect team cohesion and outcomes. Individual team members have key roles in assuring effective team communication and performance through the transfer of critical information during handoffs. Training through simulation leads to the appreciation that the technical skills of team members may be secondary to the non-technical skills, such as communication, in the performance of highly reliable teams.


Sue E. Bell

First Committee Member

Hans P. de Ruiter

Date of Degree




Document Type



Master of Science in Nursing (MSN)


School of Nursing


Allied Health and Nursing

Creative Commons License

Creative Commons Attribution-Noncommercial 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial 4.0 License



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