An observational analysis of surgical team compliance with perioperative safety practices after crew resource management training.
BACKGROUND
Acknowledging the need to improve team communication and coordination among health care providers, health care administrators and improvement officers have been quick to endorse and invest in aviation crew resource management (CRM). Despite the increased interest in CRM there exists limited data on the effectiveness of CRM to change team behavior and performance in clinical settings.


METHODS
Direct observational analyses were performed on 30 surgical teams (15 neurosurgery cases and 15 cardiac cases) to evaluate surgical team compliance with integrated safety and CRM practices after extensive CRM training.


RESULTS
Observed surgical teams were compliant with only 60% of the CRM and perioperative safety practices emphasized in the training program.


CONCLUSIONS
The results highlight many of the challenges the health care industry faces in its efforts to adapt CRM from aviation to medicine. Additional research is needed to develop and test new team training methods and performance feedback mechanisms for clinical teams.
France
Daniel J
DJ
Department of Anesthesiology, Vanderbilt University Medical Center, Medical Arts Building, Suite 732, Nashville, TN 37212-1212, USA. dan.france@vanderbilt.edu
Leming-Lee
Susie
S
Jackson
Tom
T
Feistritzer
Nancye R
NR
Higgins
Michael S
MS
D006348:Cardiac Surgical Procedures / Q000592:standards; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007318:Inservice Training; D033183:Interdisciplinary Communication; D007857:Leadership; D019300:Medical Errors / Q000517:prevention & control*; D019635:Neurosurgical Procedures / Q000592:standards; D015279:Organizational Culture; D010348:Patient Care Team; D010820:Physicians / Q000592:standards*; D017410:Practice Guidelines as Topic; D017751:Safety Management / Q000592:standards*; D013514:Surgical Procedures, Operative / Q000592:standards*; D013647:Task Performance and Analysis; D013714:Tennessee; D014481:United States