Tenisha Preston, RN, is a perioperative nurse and currently serves as the Nurse Navigator for Vanderbilt University Medical Center Perioperative Services. Tenisha has 22 years of experience in nursing and 18 years of experience in the Perioperative field of nursing. Tenisha has always been widely known and acknowledged for her skills in building a rapport with patients and working effectively with a wide range of surgeons, technologists, nurses and ancillary staff. Tenisha is currently pursuing her CNOR certification. She offers years of experience in the perioperative field of nursing, serving as an educator and preceptor for all service lines within the operating room. She has also served in the leadership role, offering guidance to Operating room nurses as they focus on decreasing turnover times for their rooms and build a rapport with their team in their individual Operating room. Presently, Tenisha is the Nurse Navigator for Vanderbilt University Medical Center Perioperative Services and in tasked with throughput and efficiency. She works alongside Dr. Justin Liberman, MD, MPH, Director of Perioperative Efficiency and has created a "one team" philosophy to help support Vanderbilt's efforts in improving efficiency in the operating room suites. Their first project, improving, First Case on Time Starts, has sustained a 20% increase in first case starts since starting the trial. They have increased communication between providers and staff including to but not limited to ancillary staff. They will continue to focus on initiatives that have a significant impact on clinical outcomes, patient satisfaction and team collaboration, providing more efficient clinical settings.