3019 - The Future of Surgical Safety: Unleashing the Potential of Dyad Leadership

Overview/Abstract: The current landscape of Retained Surgical Item (RSI) prevention reveals a compelling paradox: despite robust protocols, preventable incidents continue to occur. These events arise not from knowledge deficits but from inconsistent execution of established policies—particularly during high-acuity, multi-team procedures. This reality presents an opportunity to rethink perioperative safety through structured nurse-physician leadership dyads, improved team communication, and system-wide accountability.

We are witnessing a transformation—embracing dyad leadership, multidisciplinary collaboration, and frontline engagement to bridge the gap between policy and practice. Through strong nurse-physician partnerships, we have implemented effective multidisciplinary interventions across more than 70 operating and procedure rooms in seven surgical departments, leading to significant reductions in harm events, improved patient outcomes, and decreased surgical costs.

Key strategies include proactive communication pathways that align policy adherence expectations across multidisciplinary teams, recognition of microculture excellence at the point of care, regular HEAL sessions to review near-miss and actual harm events, individualized coaching and mentorship, alignment of behavioral expectations with organizational values, and consistent evaluation through robust feedback mechanisms.

These initiatives have resulted in zero RSIs and performance that surpasses national benchmarks for over 12 months, with notable reductions in wrong-site surgeries and surgical burns. This abstract underscores how dyad leadership and frontline engagement can close the policy-practice gap, shifting from reactive compliance to proactive culture-building—ultimately fostering a sustainable culture of safety and excellence in perioperative care.