Our regular debriefing sessions at St. Francis include everyone in the OR – anesthesia, surgeons, nurses, techs, PA’s,perfusionists and hospital administration. This effort illustrates that we acknowledge communication has been dysfunctional in the cardiac surgical OR in the past. Sadly, this problem is known to be responsible for a considerable portion of preventable adverse events at other institutions analyzing this issue. The main goal of our weekly meetings is to get past the traditional one-sided communication (i.e. surgeon tells staff what to do) into a new two-way approach that taps into the insights and wisdom of others in the room. To accomplish this, the lead surgeon is responsible for creating an environment where everyone feels comfortable speaking out. It has been helpful to follow the model of military debriefings where military ranks are temporarily ignored to allow each member to become an equal witness for the duration of the debriefing. Obviously, this activity is attractive to OR staff because it empowers them to help problem solve and avoid surgical complications. In addition, our hospital's commitment to the speedy resolution of problems identified in the debriefing process has been an important part of why this activity has been popular even among the surgeons asked to cede control.