Throughout the health care community, small groups of individuals work together as teams. Physicians, nurses, pharmacists, technicians, and other health professionals must coordinate their activities to make safe and efficient patient care a priority. However, even though a myriad of the conditions addressed by health professionals require interdisciplinary teams, members of these teams are rarely trained together, and they often come from separate disciplines and diverse educational programs.
Given the interdisciplinary nature of the work and the necessity for cooperation among the workers, one can conclude that teamwork plays an important role in ensuring patient safety and avoiding errors. Teams make fewer mistakes than do individuals do, especially when each team member knows his or her responsibilities.
However, simply installing a team structure does not automatically ensure it will operate effectively. As leaders, managers and consultants how do we address this issue?
- Who is trained? What kind of training, simulation vs. in class.
- Are there new team development models worth investigating beyond Aviation and Racing Car Pit workers?
Crew Resource Management (CRM), a sub-domain of team training is a system used in medical training inspired by aviation training. Many involved in the training consider CRM in medicine has tremendous potential based on its success in aviation. However, trainers have cautions regarding this method until additional research is established. During the last few years, the medical field has developed several medical-team training (MTT) programs, some implemented in the military and some developed for civilian medicine.
Time is of essence in both the Emergency-room (ER) and a NASCAR race. Recently a crew of doctors visited the car race event to observe the high level of preparation and coordination of the “pit team. NASCAR teams are perfectly synchronized and approach the car from planned directions and carrying all the necessary tools and parts on them, doctors often enter the ER just to start asking nurses to gather, every time new tools, machines and drugs. Of course, there is at least one major difference between the two situations: pit teams can prepare and rehearse for a known situation, while the doctor has first to figure it out. However, there is an opportunity for ER teams to reconsider, plan, train and prepare routine time saving procedures that can possibly save additional lives and reduce operating cost. Bottom line innovation comes from various areas, sometimes unrelated to the industry in question. For consultants, managers and leaders these are innovations or examples of "thinking out of the box".
2 comments:
Tell me more about the aviation techniques used. What type simulations are used in the ER?
What practices in the business world can assist the medical professionals to be more efficient and prepared when emergencies strike? Immediately I thought you would cover disaster recovery and business continuity simulations.
CRM training originated from a NASA workshop in 1979, which found that the primary cause of most aviation accidents was human error. CRM has since been adapted to different industries and organizations. CRM training encompasses a wide range of knowledge, skills and attitudes including communications, situational awareness problem solving, decision-making, and teamwork. CRM can be defined as a management system, which makes optimum use of all available resources - equipment, procedures and people - to promote safety and enhance the efficiency of flight operations.
Population based research suggests that in the United States between 44,000 and 98,000 patients die each year from preventable errors, making medical error the eighth most common cause of death. Research in safety critical industries tells us that to overcome the problem we must understand the process used to deliver care. Historically, medical and aviation workers have been expected to function without error. In aviation, perceptions of fatigue, stress, and error continue to be topics of training and targets for improvement. Moreover, progress has been made to create a culture in aviation that deals effectively with error, whereas in medicine the approach is very conservative toward change management or process improvement.
Audrey, this is a fascinating area of continuous process improvement for Project Managers, Change agents, Medical personnel and people who want to stay healthy. I am involved in studying CRM applications in health care and other time critical-safety areas. Bottom line, there are medical practitioners willing to consider “other ways to provide care, that’s the nature of research. My interest is team performance and process improvement. Listed below are additional sites for more information and professional studies.
Resources
http://www.ahrq.gov/clinic/ptsafety/chap44.htm
http://www.bmj.com/cgi/content/full/320/7237/745
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