1044 - Safety Coach Simulation Training: Empowering Nurses to Speak Up in the Operating Room

Overview/Abstract: Speaking up in the operating room (OR) can be difficult, particularly in high-stakes situations where hierarchy and time pressure challenge open communication. Recognizing the need to strengthen the culture of safety, Hershey Medical Center transitioned from a traditional, lecture-based safety coach model to a dynamic, simulation-based training program designed specifically for the perioperative environment.

This interdisciplinary initiative empowered nurses, surgical technologists, physicians, and advanced practice providers to recognize safety concerns and respond confidently and effectively in real-time. Through realistic, emotionally charged scenarios—such as discrepancies in surgical consents or breaks in surgical count protocol—staff practiced using safety behaviors and error prevention tools in a psychologically safe setting. These scenarios were developed to reflect true-to-life tensions and foster skillful navigation of difficult conversations, assertive communication, and team accountability.

Core components of the program included simulation-based training, real-time leadership coaching, division-specific customization, and focused education on psychological safety. Post-training outcomes were compelling: staff demonstrated a 105% increase in recall of safety behaviors and a 28% increase in comfort speaking up. More importantly, the initiative resulted in measurable changes in practice, including increased use of “stop the line” protocols and greater interprofessional collaboration in addressing safety concerns.

This presentation will explore the strategies used to design and implement this program, the cultural transformation it catalyzed, and how it can serve as a scalable model to strengthen psychological safety, elevate team communication, and reduce risk in surgical settings. Attendees will leave with actionable insights to empower their teams and improve patient outcomes.