Can aviation-based team training elicit sustainable behavioral change?

Area of Science:

• Healthcare Management
• Patient Safety
• Aviation Safety

Background:

• Healthcare settings face challenges in maintaining patient safety.
• Crew Resource Management (CRM) training, originating from aviation, offers a framework to improve teamwork and safety.
• Quantifying the impact of CRM on healthcare professionals' behaviors and empowerment is crucial.

Purpose of the Study:

• To evaluate the effectiveness of aviation-based Crew Resource Management (CRM) training.
• To measure changes in patient safety-related behaviors.
• To assess the impact on perceived personal empowerment among healthcare staff.

Main Methods:

• A prospective study involving 857 participants (nurses, ancillary, physicians) across university and community hospitals.
• Intervention included CRM training.
• Outcomes measured via preoperative checklist use, a web-based incident reporting system, and a 10-point safety empowerment survey administered pre-training, immediately post-training, and 2 months later.

Main Results:

• Preoperative checklist use increased from 75% to 100% over the study period.
• Self-initiated incident reports nearly doubled, with a significant increase in environment-related reports (15.9% to 20.3%).
• Perceived self-empowerment scores rose significantly (0.5 points) and were sustained at 2 months, though a trend showed less comfort confronting physician incompetence.

Conclusions:

• Crew Resource Management (CRM) programs can positively influence individual behaviors and enhance personal empowerment within healthcare.
• The integration of CRM principles can contribute to a more robust safety culture.
• Sustained effects of CRM training may require long-term reinforcement to become fully ingrained in the organizational culture.