A crew resource management program tailored to trauma resuscitation improves team behavior and communication

Area of Science:

• Healthcare Management
• Patient Safety
• Team Communication

Background:

• Crew Resource Management (CRM), originating in aviation, enhances team dynamics and safety.
• CRM has been successfully applied in healthcare, particularly in critical care settings.
• This study adapted CRM for the unique environment of trauma resuscitation.

Purpose of the Study:

• To adapt and implement a Crew Resource Management (CRM) program within a trauma resuscitation setting.
• To evaluate the impact of CRM training on team communication, dynamics, and patient safety in trauma care.

Main Methods:

• An interdisciplinary committee developed a CRM program, including a didactic course informed by a pre-implementation survey.
• The Human Factors Attitude Survey and Communication and Teamwork Skills assessment tools were used for program design and evaluation.
• CRM training was delivered to 324 staff over three months, with pre- and post-training assessments.

Main Results:

• Post-CRM training surveys showed significant improvements in communication accuracy between field and medical command (p=0.029) and within the emergency department (p=0.002).
• Team dynamics, including leader identification, communication of plans, and role assignment, improved significantly (p=0.001).
• Staff reported increased willingness to voice patient safety concerns post-training (p=0.002).

Conclusions:

• Crew Resource Management implementation in trauma resuscitation demonstrably enhances team dynamics and communication.
• The findings suggest CRM positively impacts patient safety in trauma care.
• Integrating CRM philosophy and culture is recommended for all trauma programs and patient resuscitation efforts.