title: The challenge of changing roles and improving surgical care now: Crew Resource Management approach.
abstract: Many surgeons are also pilots; the two activities demand similar skill sets. Surgeons have developed an interest in aviation models for managing risk and reducing adverse events, such as Crew Resource Management training. This article provides seven suggestions from aviators that might be adopted by surgeons in an effort to improve surgical care and mitigate patient harm. Each suggestion is offered based on the value added to aviation, with an acknowledgment that the suggestion may be more or less applicable in surgery. The suggestions for dealing with the changing roles for surgeons are: Crew Resource Management-type training to improve teamwork should be required for hospital credentialing, surgeons should brief the operating room team before an operation, surgeons should write standards specific to their organization, surgeons should recognize fatigue and age as factors in performance, surgeons should have "check-rides" as a part of the credentialing process, surgeons should abandon the mortality and morbidity conference in favor of a data collection system that effectively examines adverse events for root causes of error, and all members of the surgical team should be subject to mandatory, random drug testing.
authors.affiliation: Department of Surgery, University of Utah, Salt Lake City, Utah 84132, USA.
authors.forename: James
authors.initials: J
authors.lastname: McGreevy
authors.forename: Tyler
authors.initials: T
authors.lastname: Otten
authors.forename: Michael
authors.initials: M
authors.lastname: Poggi
authors.forename: Christopher
authors.initials: C
authors.lastname: Robinson
authors.forename: David
authors.initials: D
authors.lastname: Castaneda
authors.forename: Patrick
authors.initials: P
authors.lastname: Wade
mesh_terms: D013502:General Surgery / Q000458:organization & administration*; D017408:Guidelines as Topic; D006801:Humans; D008330:Management Audit / Q000379:methods*; D011785:Quality Assurance, Health Care / Q000639:trends*; D013514:Surgical Procedures, Operative / Q000592:standards*; D014481:United States