Crew resource management training in the intensive care unit. A multisite controlled before-after study

Area of Science:

• Healthcare Management
• Patient Safety
• Medical Education

Background:

• Adverse events in intensive care units (ICUs) are often linked to non-technical skill deficits rather than clinical expertise.
• Team training programs like Crew Resource Management (CRM) are designed to enhance these crucial non-technical skills.

Purpose of the Study:

• To evaluate the effectiveness of Crew Resource Management (CRM) training in improving non-technical skills and patient outcomes within the ICU setting.

Main Methods:

• A paired controlled trial involving six ICUs, with three receiving CRM training and three serving as controls.
• A 2-day classroom-based training for multidisciplinary ICU staff, assessed using Kirkpatrick's four-level evaluation framework.
• Mixed-methods design incorporating questionnaires, observations, and patient outcome data over 12 months.

Main Results:

• High participant satisfaction (Level I) and stable attitudes towards situational awareness (Level II).
• Improved self-reported situational awareness behaviors (Level III) and enhanced error management culture and job satisfaction.
• No significant changes in observed communication or patient outcomes; patient safety culture improved in both groups.

Conclusions:

• CRM training positively influenced participants' perceptions of errors and risks but did not independently alter clinical behavior or patient outcomes.
• CRM is a valuable component but requires integration with other strategies to effectively improve clinical outcomes in the ICU.