Specific CRM behaviors have been identified through experimentation and observation of high-reliability teams in demanding, time-stressed environments such as combat aviation and naval command and control centers (Leedom and Simon 1995 McIntyre and Salas 1995). An additional principle is that those behaviors, although seen spontaneously, are not practiced reliably, regularly, or well unless specific training and reinforcement has established them. The basic principle of CRM is that crew communication and coordination behaviors are identifiable, teachable, and applicable to high-stakes environments. aviation crews and air carriers operating internationally (Helmreich and Foushee 1993 Helmreich 1997). The aviation community began introducing CRM training two decades ago and it is now required for all military and commercial U.S. Similar analyses attribute about 80 percent of anesthesia mishaps to human error and 70 percent of commercial aviation accidents to crew errors (Gardner-Bonneau 1993 Taggart 1994).Ĭrew training has led to reductions in aviation mishaps beyond those produced by improvements in equipment and technology. In 43 percent of the cases reviewed, teamwork behaviors would have prevented or mitigated the adverse event had they been applied (Risser, Rice et al. A retrospective review of ED closed claims revealed that failure to engage in one or more of these teamwork behaviors was associated with an adverse event and indemnity payments. Preliminary observations in emergency departments (ED) established that the same CRM behaviors employed by highly effective aviation teams could be useful in the ED (Weiner, Kanki, and Helmreich 1993 Simon, Morey, and Locke 1997). Hospital emergency departments share many of the same characteristics with workplaces where CRM is effective, such as time-stress, dispersed and complex information, multiple players, and high-stakes outcomes. Abstract: The MedTeams project is a translational research effort to apply crew resource management (CRM) behavioral principles developed in aviation to emergency medical care.
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