Description: As health care system continue to evolve through the years, perioperative suites cater to more types of surgical procedures. The trend of developing highly specialized teams has improved not only physician satisfaction, staff retention, but also patient care metrics. However, Level 1 Trauma institutions should ensure global staff competency to emergency surgeries which includes neurosurgical trauma procedures. Ensuring neurosurgical trauma competency of all staff members of a level one trauma facility can be tricky especially in the world renowned, Texas Medical Center where staff turnover is high and neurosurgical trauma emergencies can happen 24/7. This poster presentation will outline the journey of one of the nation’s busiest Level 1 Trauma facility towards continuous perioperative team competence and preparedness for neurosurgical trauma emergencies.