crew resource management in medicine - soap 2007 presentation for... · crew resource management in...
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CREW RESOURCE CREW RESOURCE MANAGEMENT IN MEDICINEMANAGEMENT IN MEDICINE
John Pawlowski, MD, PhDJohn Pawlowski, MD, PhDBeth Israel Deaconess Medical CenterBeth Israel Deaconess Medical Center
Boston, MABoston, MA
CON: OutlineCON: Outline
It’s not a fad.It’s not a fad.It improves communication.It improves communication.It prevents accidents.It prevents accidents.It saves lives.It saves lives.
Definition: FadDefinition: Fad
A temporary fashion, notion, A temporary fashion, notion, manner of conduct.manner of conduct.
Definition*: Definition*: FadFad
A temporary fashion, notion, manner A temporary fashion, notion, manner of conduct.of conduct.From obsolete From obsolete faddlefaddle to play with, to play with, fondlefondle
* The Random House Dictionary, 2* The Random House Dictionary, 2ndnd Edition, Edition, UnabridgedUnabridged
Definition: Crew Resource Definition: Crew Resource ManagementManagement
= Team Training= Team Training= Crisis Resource Management= Crisis Resource Management= Safety Culture Training= Safety Culture Training= Root Cause Analysis= Root Cause Analysis= Error Management= Error Management= Human Factor Analysis= Human Factor Analysis
What is the number 1 reason for What is the number 1 reason for disasters?disasters?
Pilot ErrorPilot Error
Nuclear Power IndustryNuclear Power Industry
Why Bother in Medicine?Why Bother in Medicine?
Not always Marcus Not always Marcus WelbyWelby, MD, MD
Data 1Data 1
Data 2Data 2
Data 3Data 3
Data 4Data 4
Data 5Data 5
Data 6Data 6
Swiss Cheese ModelSwiss Cheese Model
Errors are multipleErrors are multiple
FADFAD--10 by ELECOM Corp.10 by ELECOM Corp.
I GIVE UPI GIVE UP
Problems due to Problems due to communicationcommunicationMedical people Medical people communicatecommunicateThere are no There are no problemsproblems
RebuttalRebuttal
We don’t practiceWe don’t practiceWe don’t keep scoreWe don’t keep scoreWe rely on fadsWe rely on fads
See one, do one.See one, do one.
Hours of practice (total)Hours of practice (total)
NBA playerNBA player-- 10,000 hours10,000 hoursNHL playerNHL player-- 10,000 hours10,000 hoursSymphony musicianSymphony musician-- 10,000 hours10,000 hoursAstronautAstronaut-- 5,0005,000--10,000 hours10,000 hours
Hours of practice (total)Hours of practice (total)
ACLSACLS-- 6 hours6 hoursCentral line placementCentral line placement-- 1 hour1 hourAdvanced airway managementAdvanced airway management-- 1 1 hourhourEpidural placementEpidural placement-- 1 hour1 hour
Fads in MedicineFads in Medicine
VagotomyVagotomyFenFen--phenphenPTCAPTCACOXCOX--22
Not just a fadNot just a fad
ConclusionConclusion
–– And Crisis Resource Management CenterAnd Crisis Resource Management Center