Introduction:
Medical errors are a frequent cause of morbidity and mortality in hospitals worldwide. Poor teamwork and communication skills rather than lack of technical knowledge have been identified as a common factor in numerous studies.
Objective:
To promote a safer medical practice through the adoption of Crew Resource Management (CRM) procedures directly adapted from the aviation industry for the first time in Argentina.
Methods:
Starting in 2009 we organized a hybrid team of two physicians/amateur aviators and two expert airline pilots with a significant background on safety analysis and CRM training . The setting for the initial experience was a teaching hospital with high volume cardiovascular and organ transplantation departments. CRM training has been offered at least once a year in a non compulsory manner to the entire spectrum of healthcare personnel, including medical and nursing students. Courses are structured in two day sessions divided in several chapters and workshops: Introduction, statistics, leadership, communication skills, and avoidance of risky behaviors. Slides, full text articles and reports are available for permanent consultation by personnel along with discussion forums at the Moodle based site of the program.
Results:
Satisfaction levels among attendees has consistently averaged 92%. Following training, briefings and debriefings have been implemented as standard procedures along with checklists both at Intensive Care, Operating Rooms and General Ward. No wrong side or wrong patient interventions have been reported over 3 years, while in 1/9500 surgical procedures a misidentification of a patient occurred with successful detection at the second crossed check on admission to the OR. Overdosing was reported in 1 every 4960 admissions, none fatal or disabling.
Conclusions:
Choosing a hybrid team of physicians and airline pilots rather than physicians or nurses alone as facilitators was a key factor to spark interest in teamwork factors and to avoid fear of punishment following reports. Despite cultural differences, CRM can be as feasible and successful in a Latin American hospital environment as previously shown in several centers in the United States.
Erratum zu: Crew Resource Management im Schockraum
