Background: 
The principal component in up to 70% of the critical incidents in anaesthesia is human factor. Among the different tools to promote patient safety, we have instituted a multidisciplinary course in Safety in Surgery and Anaesthesia focused in training high performance teams with the collaboration of the Anaesthesia and Intensive Care National Incident Reporting System (SENSAR) and industry stakeholders. The workshop, intended for surgeons, anaesthesiologist, nurses and other non-surgical professionals, was held at a national level. The goal of our study was to compare the results of a survey administered before and after the workshop to the participants at HGUGM and the other Spanish hospitals.

Material and Methods: 
The course design included 2 phases: a face-to-face seminar and online content delivery. 
During the seminar, a brief introduction about patient safety was made, followed by sessions on critical incident, underlying factors, human factor, CRM (crisis resource management), debriefing method and non-technical skills. Using video simulation, we recreated different scenarios in which patient’s safety has been compromised.
Before and after the workshop a survey was provided to participants querying the following items: 
* Pre-session: general data of the participants, general knowledge about patient safety, human factor and teamwork, CRM, learning discussions and emotion, behaviour and communication skills.
*  Post-session: survey emphasised in: relevance of what they learnt for daily work, the impact in safety patient, communication skills, and the necessity for repeated training.  

Results:
Nine sessions with a total of 159 participants were held in Spain from January to November of 2016. Six of them took place at our hospital. We included 90 participants in groups of 15 in each session (anaesthesiologist, surgeon and nurse of the same surgical field), as well as other non-surgical professionals (haematologist, neonatologist, pharmacists, etc.). Although most participants had prior training on safety, a lack of formation in non-technical skills figures prominently in our hospital (73%) and others (62%); as well as an absence of adequate coordination of the surgical team. Similarly, in all the hospitals, (77% HGUGM - 72.7% others), the participants had never received a workshop like this, neither know-how to implement a debriefing (61.4% and 50%) or CRM methodology. All the surveys show, when we compare our hospital to the rest of the Spanish hospitals, a p>0.05 therefore, we can conclude that this workshop can be transferred to all other hospitals, with similar results.

Conclusions:
Training workshops for multidisciplinary high performance teams is a tool capable of Improving Safety Culture in Surgical Environments. This workshop is a new tool to enhance no-technical skills and to improve coordination between professionals. Data suggest that periodic training is necessary to maintain the formation level.

High performance teams building: development of a new tool in patient safety