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Consider crew resource management training

Staff Development Weekly: Insight on Evidence-Based Practice in Education, October 18, 2007

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Crew resource management (CRM) is a team-training approach that healthcare has adopted from the aviation industry. Although comparisons are often made between the two industries, there are significant differences that can make translating the team concept challenging. Those differences can include:

• Checklists. One of the biggest differences between healthcare and aviation is the reliance on checklists in aviation. Checklists are thoroughly vetted and, over the years, have taken a form that is hard to misunderstand. However, in healthcare, checklists vary from facility and facility and can be confusing. Standardizing language and asking for specific information can transform a Universal Protocol checklist into a definitive tool to help reduce wrong-site, wrong-procedure, or wrong-patient surgeries. Stating the obvious in a patterned way can also help confirm information.
• Briefings. Aviation uses more briefings and debriefings to discuss what should happen and what has happened, respectively. Most processes in the cockpit follow a script complete with actual lines to address all questions. Aviation team members also refer to everyone by their names as a way to make sure they have their attention.
• Simulation. Aviation places a strong emphasis on automated simulation of lifelike conditions. Simulators are huge and incredibly expensive, and they are a required training element for pilots. However, in medicine, mechanical and automated simulation is rare. Simulators in medicine are nowhere near where they are in aviation; pilots are constantly in training and recertifying their licenses.

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