Despite some controversy over their effectiveness, teamwork training programs continue to emerge with a growing focus on the adoption of specific tools. This study engaged all operating room (OR) personnel for a 1-day training program and tracked a number of subsequent outcome measures, including metrics of OR function and use of a standardized debriefing and perioperative checklist. One year following the team training, case delays decreased from 23% to 10%, mean case scores assigned increased significantly in the positive direction, and findings were sustained at 24 months. In addition to OR team function, adherence to guidelines for prophylactic antibiotics improved, and surveys noted improved perceptions of teamwork and safety culture. This study extends the noted benefits of teamwork training programs, particularly when combined with an active debriefing process, on objective measures of change in OR function.