Communication and teamwork are essential components of safe patient care. This evidence-based practice project evaluated the communication and teamwork the operating room staff engaged in during 30 surgical procedures (ophthalmology, plastics, or otorhinolaryngology). Findings provided insight into whether or not the communication and teamwork education that occurred in August, 2012 for registered nurses and surgical technologists was sustained and encultured. This descriptive project utilized a convenience sample consisting of approximately fifty staff members who work in the operating room of a teaching hospital, including surgeons, anesthesiologists, residents, certified registered nurse anesthetists (CRNAs), registered nurses, and surgical technicians. To evaluate the quality of communication the Communication and Teamwork Skills (CATS) Assessment Tool was used. From 2012 to 2014, improvement in CATS scores was marked: for example, the score for the communication category went from 91.60% to 99.5% and that for the coordination category from 93.50% to 97.6%.Study findings suggest that education and quality monitoring with teaching moments improve team-based outcomes and, ultimately, increase patient safety. All operative team members should not only be competent in their individual roles but should also work together in a structure exhibiting the expertise of team members functioning synergistically as team members. A nursing competency with a post-test component on communication and teamwork will be developed.