J Clin Outcomes Manage
Crew resource management in perioperative services: navigating the implementation road map
Leming-Lee S, France DJ, Feistritzer NR, Kuntz A, Sanders F, Higgins MS
Abstract Objective: To describe the implementation of crew resource management (CRM), a patient safety practice derived from the domain of commercial aviation, in the perioperative environment at an academic medical center. Methods: Vendor training emphasized 6 key areas: (1) managing fatigue, (2) creating and managing a team, (3) recognizing adverse situations, (4) cross-checking and communication techniques, (5) developing and applying shared mental models, and (6) giving and receiving feedback. A steering committee was created to provide oversight of the design and implementation of health care CRM. Multidisciplinary work groups developed CRM tools for each of the 3 perioperative work phases (preoperative, intraoperative, postoperative). Following pilot testing, staff feedback was obtained and suggestions for improvements were made. Results: 737 providers working in 43 holding rooms and operating rooms in an academic medical center have been trained in CRM. Providers in neurosurgery and cardiothoracic surgery have participated in an internally developed implementation program and have provided feedback on their experiences. Conclusion: Translating CRM to health care is a resource- and time-intensive endeavor that requires domain-specific planning and training. The successful translation of CRM to health care will require time, collaboration, and the sharing of experiences.
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