Hospitals adopt NASA ways

August 19, 2013 in Medical Technology

Lean may be the biggest craze these days in creating efficiencies in hospitals and health systems, but some facilities are having success with a process that got its start at NASA.

Crew resource management – also known as cockpit resource management – developed out of the aviation industry, said Richard Doss, senior advisor for performance breakthroughs and strategy at LifeWings Partners, a Tennessee-based provider of teamwork training.

It was used in aviation to institute procedures to avoid human error and the disasters that can sometimes happen because someone makes a mistake.

Over the years, CRM has been adopted in a number of other industries. The healthcare industry began showing interest in the process about 12 years ago, said Doss, who has worked with a number of hospitals to introduce and train staff on CRM.

[See also: National pilot engages cancer patients.]

CRM is based on interpersonal communication and decision making – qualities that, historically, are alien in many clinical settings, Doss noted, which means that instituting the process often means changing a department’s or a facility’s culture. 

At Memorial Health System’s six hospitals in South Florida, surgeons and anesthesiologists had some concerns about CRM, said Joseph Loskove, MD, the system’s chief of anesthesia.

Mainly, they were worried the debriefing tool that was being established in the operating rooms as a result of using CRM would add time in the ORs. It had the opposite effect. Using the debriefing tool has made surgeries more efficient because less time is spent having to leave the sterile environment to obtain additional needed instruments or assemble equipment, Loskove said.

Overall, Memorial has seen improved quality and safety,  patient experience and satisfaction and improved employee and physician satisfaction, Loskove said.

The surgical areas at the University of New Mexico Health Sciences Center faced a tougher challenge than at Memorial.

“You have to understand that our operating room was a tough, tough environment,” said David Pitcher, MD, UNM Health Sciences Center’s chief medical officer. “There was serious skepticism on the part of a number of staff and a number of the physicians.”

[See also: EHRs, tech help docs avert misdiagnosis.]

Based on the University of New Mexico’s Albuquerque campus, UNM Health Sciences Center is the state’s largest academic health complex. Before the ORs began instituting CRM in 2009, the organization had a problem with harm events occurring in the OR. Various tactics had been tried to reduce harm events in the ORs, said Pitcher, to no avail.

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