INTRODUCTION
Teamwork has been associated with higher level of job satisfaction, higher quality of care, Increase in patient safety, greater patient satisfaction with their care, a higher level of productivity, and a decrease in stress levels.  Studies have tested interventions to imprové teamwork including cross training, role playing, simulation, automation, feedback, and team building.  Within nursing, only a few studies designed to improve teamwork have been conducted.  This study tests an intervention to enhance staff teamwork and engagement.  The study question is as follows:: What is the impact of an intervention designed to enhance teamwork and staff engagement on the rate of patient falls, patient satisfaction, the staff’s assessment of level of teamwork on their unit, and vacancy and turnover rates?
METHOD
A nine step intervention was conducted on a 41 bed medical oncology patient care unit.  The steps in the process were:  (1) focus groups with all staff; (2) feedback of the results;  (3) development of vision, values and goals; (4) teamwork training; (5) formation of a guiding team; (6) creative problem solving sessions; (7) rapad testing and implementation of ideas; (8) on-going two way communication with all unit staff about the changes; and (9) follow-up coaching and reinforcement of team skills.
FINDINGS
Patient falls, patient satisfaction, staff ratings of teamwork, vacancy and turnover rates were the before and after measures for this study.  Patient fall rates decreased significantly (t  = 3.98, df=64, p= 0.00).  Staff felt that teamwork had increased significantly  (X2 = 36.065, df = 2, p=0.000) and both turnover (t = 2.18, df =  63, p= .033) and vacancy rates (t =  4.55,  df= 58, p= .0000) decreased after the teamwork intervention.  The results of this study demonstrate that high level nursing teamwork can be achieved and the outcomes are both quality enhancing and cost reducing.