Description: Clinical Issue Safe transfer of the perioperative patient with a BMI > 40 can present challenges to the Perioperative team and the patient. Patients who are able to transfer with minimal support pre-operatively may have physical limitations post-surgery. In addition, work related injuries related to lifting or straining as well as patient injuries caused by friction and shearing may occur. Our Perioperative team elected to trial an inflatable air assisted lateral transfer matt to assist in the safe transfer of the perioperative patient. Description of Team Stakeholders included perioperative nurses, surgeons, anesthesia providers, and perioperative support staff. We also engaged a senior web developer to serve as an informatics content expert. Preparation and Planning Members of our team met with Perioperative leadership to discuss the implementation of the transfer device. We expanded the dissemination of a previously created electronic report to perioperative supervisors and coordinators. This report depicts all patients with a BMI>40, patient demographics, and scheduling information. In addition, the team reviewed the volume of patients with a BMI>40 over the last six months to determine cost, quantity, and storage of additional transfer matts and air machines. Assessment Although we had a few of these devices previously available, usage was very low because we lacked a defined process for utilization. We performed interviews with frontline nursing and support staff to understand barriers to using the device. We also reached out to other procedure areas where the device was being used routinely to better understand how this had been enculturated into routine practice. Implementation We created a communication plan as well as a plan to use the device for all patients with a BMI>40 and disseminated to all stakeholders. We performed simulations on staff volunteers. We conducted one on one education to nurses, surgeons, and anesthesiologists using the device during patient transfers. In addition, the support managers communicate which patient rooms need the device and deliver the matt and air machine prior to patient arrival. The assigned rooms are also discussed at the daily safety huddle with the perioperative team. Outcome The utilization from April 2019 through February 2020 is 79%. Barriers include the team forgetting the matt is placed on the bed and or the support team neglecting to place the device on the bed prior to patient transfer. We are also challenged by team acceptance to use the device, especially on a patient of size who may be able to move themselves. Implications for Perioperative Nursing The Perioperative Nursing department fosters a culture of safety by collaborating with all team members to promote safe patient transfers. Preventing injuries relating to lateral transfers and transferring patients without lifting or straining supports employee and patient safety.