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Crew Resource Management
Crew Resource Management (CRM) Can Help
Improve Your Hospital:
Crew Resource
Management (CRM) is the safety system employed by high reliability
organizations to help ensure positive outcomes in high-risk
situations. CRM originated in 1979 to address the impact of human
errors on the safety of commercial aviation flights. The
National Transportation Safety Board defines CRM as
"using all available sources—information, equipment, and people—to achieve
safe and efficient flight operations."
CRM involves team training, safety tools, measurement systems, and
simulation to:
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Manage fatigue
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Improve teamwork
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Proactively address potential problems
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Use cross-checking tools to catch mistakes before they become
serious and avoid mishaps
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Utilize effective
communication skills to ensure better decisions and provide
feedback for continuous quality improvement.1
The Medical Community has
Widely Endorsed the use of CRM Concepts as a Way of Improving
Patient Safety:
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In their report
Health Care at the Crossroads: Strategies
for Improving the Medical Liability System
and Preventing Patient Injury,
the
Joint Commission
recommends CRM for improving healthcare
and states that implementing CRM concepts "could increase the
timeliness and accuracy of communications – breakdowns of
which are commonly implicated sources of serious adverse events. This could also help to enlist clinicians and support staff in
committing to a common goal – safe and effective care – in the
often high-pressure and chaotic environments of healthcare."
-
The
Agency for Healthcare Research and Quality,
the division of the Department of Health & Human Services
dedicated to improving "the quality, safety, efficiency, and
effectiveness of health care for all Americans", lists Crew
Resource Management as a complementary way to improve patient
safety because "some
mistake-proofing devices reduce the need to attend to process
details. This reduced cognitive load can free resources and
facilitate effective participation in decision making typical in
CRM."
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Numerous studies
have been conducted which reveal a positive outcome of CRM
training in healthcare settings including the International
Journal for Quality in Health Care study
"Effect
of crew resource management training in a multidisciplinary
obstetrical setting"
which concludes CRM "contributes to a significant improvement in
interprofessional teamwork."
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In his 2000
Testimony on Patient Safety and Medical
Errors, John M. Eisenberg, M.D., Director, AHRQ,
stated: "Our current culture emphasizes an approach often
referred to as 'name you, blame you, shame you'. We know that
such approaches only encourage clinicians to hide their
mistakes. As the IOM report notes, we can learn from the
experience of the aviation industry in this regard. Once fraught
with accidents, the aviation industry today can serve as a model
for how to build a safe system. The key to their success was
abandoning a 'blame the individual' approach. Abandoning that
approach led to an increase in reporting of errors and 'near
misses'. They rigorously analyze those events and re-engineer
the plane's systems and processes, using human factors analysis
and applying teamwork, guidelines, automation, simplification,
and standardization to as many functions as possible. Our health
care system must take similar steps. By creating an environment
where clinicians can share their mistakes, we can begin to
develop systems that will ensure that these errors will not be
repeated."
LifeWings is Uniquely Qualified
to Help Your Hospital Employ CRM to Improve Patient Safety and
Financial Viability:
Adapting the key
concepts of CRM to healthcare has had significant results. In 2001
LifeWings founder,
Steve Harden,
a CRM expert for both the U.S. Navy and FedEx, co-author of "CRM: The Flight Plan for Lasting Change in
Patient Safety", the definitive how-to text on
implementing aviation-based safety tools in healthcare, and
co-founder of Crew Training International, the world's largest
provider of CRM training for aviation organizations, developed a
program that applied CRM principles to healthcare delivery teams.
His program, the
LifeWings Patient Safety Improvement
Program has reduced
medical errors,
improved employee satisfaction, and saved lives at more than
85 healthcare facilities nationwide.
The overwhelming success of the program and the intense public
interest in improving healthcare quality has resulted in
significant media attention
and
client praise.
The LifeWings
adaptation of CRM for implementation in healthcare:
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Prepares healthcare leadership to lead a permanent and
sustainable cultural change initiative;
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Provides world-class, customized, experiential, evidence-based
teamwork and communication skills training;
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Establishes teamwork performance standards and creates
willingness in the staff to hold one another accountable to
those standards;
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Re-ignites a passion for great care and instills a sense of
"ownership" in the process of care at all levels of the
organization;
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Creates site-specific, purpose-built safety tools that hardwire
behavior change and mitigate the effect of inevitable human
error;
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Develops comprehensive measurement systems to document results
and monitor progress goals.
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Read What
Clients Say About LifeWings CRM-based Programs:
“The two-day workshop… was very
helpful and should be a part of medical training. In particular, I
was impressed with the 'see it, say it, fix it' culture that accepts
and rewards a bottom-up approach to potential problems. If hospitals
were to adopt this change in culture, I believe less mistakes and
complications would occur. Team building in medicine is important
and should be emphasized in the practice of medicine. The approach
used by LifeWings is innovative and important for doctors and
hospital administrators to learn more about.”
Dr. Frank H. Boehm
Professor of Maternal/Fetal Medicine
Director of Obstetrics
Vanderbilt University
"The program is well thought-out in respect to healthcare. LifeWings
presents the training in a manner that shares the expertise of the
aviation industry but is respectful of the clinician. This is a
unique talent that engages the audience and moves people to action.
In the four-hour session, even when a physician was paged they
returned immediately. I don't know if you realize how this signals
the value of what they felt they were getting from the training, but
it is huge! LifeWings far exceeded our expectations. We have been
able to get 100% buy in from our physicians and staff. I couldn't
sing your praises any more. This is an excellent program."
Joan Cappelletti
Women's & Children's Service Line Administrator
Provena Saint Joseph Medical Center
“Very insightful! Great correlation between air traffic safety and
healthcare safety. Real-life situations gave the focus and points
more impact.”
Deborah Gregory, BSN, MSN
Director, Cardiac Services
Centennial Medical Center
“This is an awesome course that makes me realize how simple this
process is, in order to make patients safer. Why haven’t we been
taught this before?”
Beverly Ligon, RN
Skyline Medical Center
More testimonials...
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The LifeWings
adaptation of CRM to healthcare delivery is
unquestionably effective. Our staff
of
patient safety facilitators and our
management all have significant
experience in CRM and human factors training. Many of our
facilitators advise the military, NASA, and other large high
reliability institutions on the effective use of CRM and develop
programs for a variety of audiences. Our team of CRM experts
includes respected physicians, astronauts, pilots, and military
personnel who possess the technical knowledge and training skills to
produce real results for your hospital.
1The impact of aviation-based teamwork training on the attitudes of
health-care professionals. Grogan EL, Stiles RA, France DJ, Speroff
T, Morris JA Jr, Nixon B, Gaffney FA, Seddon R, Pinson CW.
Department of Surgery, Vanderbilt University, Nashville, TN
37232-9485, USA.
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