Initial implementation of mixed reality simulation targeting teamwork and patient safety.

Patient safety is one of the most pressing challenges of modern healthcare. Being a multifactorial problem, patient safety requires improvement interventions on multiple levels including individual, team and organization as a whole. Using high-fidelity human patient simulator in real clinical setting allows creating a mixed reality environment for teaching healthcare teams to improve patient safety. A multidisciplinary group of physicians at Louisiana State University Health Sciences Center in New Orleans has developed and implemented the STEPS program (System for Teamwork Effectiveness and Patient Safety) with the use of MMOR (mobile mock operating room) configuration to train general surgical teams within their own operating room environment. Each simulation session was followed by facilitated debriefing and teaching new team communication skills. Team performances were assessed by both direct observation and team's self-assessment where each team member assessed his or her own performance as well as the performance of all other team members (360 degree assessment).