The crew resource management (CRM) training not only improves safety in aviation but is also useful for intensive care unit (ICU) personnel, researchers of the Dutch Radboud University Medical Centre discovered. Their prospective cohort study of three years was published in Acta Anaesthesiologica Scandinavica and describes the effects CRM on the ICU complication rate.
CRM is based on the standardisation of communication and teamwork to prevent human errors and improve efficiency. The strategy emphasises the importance of evaluating prior situations and using feedback. Implementation of CRM in the ICU comprised a two-day staff course, the formation of a CRM Core Group andweekly discussions during team meetings, as well as additional training sessions.
Next to the rates of complication, such as cardiac arrests and cardiopulmonary resuscitation, hospital length of stay and standardized mortality ratio were monitored during the three-year study. The first year was used for baseline measurements, followed by two years of CRM implementation.
The study results show a reduction of the ICU complication rate from 67.1 per thousand patients in the first year to 50.9 in the third year. Additionally, cardiac arrest incidence dropped from 9.2 per thousand patients to 3.5, while the number of successful cardiopulmonary resuscitations increased.
Because of the non-randomised, single-centre study, the scientists warn that extrapolations of these outcomes should be used cautiously. However, since the measured rates remained constant during the two years prior to the study, it is unlikely that the observed effects are caused by random fluctuations.
Surgeon Marck Haerkens, first author of the publication, is pleased with the results: “To our knowledge, this is the first scientific evidence for the effectiveness of CRM in the ICU. We therefore strongly advise the implementation of CRM in a broader range.”
Sources: Radboudumc, Acta Anaesthesiologica Scandinavica
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