In June 2001, members of the KP Northwest Region (KPNW) Patient Safety Team attending a Human Factors training program considered the patient safety challenges faced in the operating suite and identified pre-operative briefing as a necessary component of safe practice. After receiving the Human Factors training, the KPNW Patient Safety Team obtained sponsorship for a pilot project to develop preoperative briefing as a way to transform the patient safety culture in the KP Northwest Region's operating suites and to reduce the number of errors (especially burns). The project led to the KP Sunnyside Medical Center's current policy requiring preoperative briefing before each surgical intervention so that information regarding the patient's care is verified and shared.Since initiation of the preoperative briefings-which are increasingly being conducted on a routine basis-a trend of decreasing accidental injuries has been observed in the operating suite. In addition, recent questionnaire responses show an improved team culture of safety and an improved overall work climate (including such factors as teamwork, safety, perceptions of management, and working conditions). Measures reported by surgical teams in Orange County (California) and KPNW indicate the project can be transferred successfully. Staff are also expanding the briefings project to the ambulatory setting.