Surgical Debriefing Research Paper

 

Objective

 

Crew Resource Management (CRM) training includes teamwork, communication, decision making, and the routine usage of checklists and protocols. The principles of CRM were developed in high-risk, high-reliability industries where mistakes cause disastrous consequences. In recent years, CRM practices have been introduced to hospitals to improve patient safety. This paper examines the role of debriefing in the operating room, in helping to make the surgical suite safer for patients.

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Accomplishments

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Through CRM training that emphasizes communication and standardized processes, Memorial has experienced outcomes that include improved quality, improved safety, reduced untoward outcomes and sentinel events, improved patient experience, and improved patient satisfaction. Although it is a natural and inevitable human condition to revert back to poor habits, CRM eliminates such process and protocol variability, substantially reducing this creep towards previous habits by requiring conscious effort and concentration at the point of care.

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Memorial saw significant increases in safety, communication, and satisfaction in every hospital as a result of implementing CRM and as evidenced through Memorial’s safety culture survey scores.

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A year following the implementation of CRM training, physician satisfaction increased  substantially in every category, including perception of overall quality, place to practice, patient safety, teamwork collaboration with nursing, and communication with nursing. In addition to physician satisfaction, Memorial’s staff members developed an extraordinary sense of teamwork combined with a high degree of personal responsibility to assure patient safety, as demonstrated by the 2010 safety survey. Here, teamwork within units and employee satisfaction experienced significant increases across every hospital. In this way, the standardization of communication procedures that CRM facilitated has created an environment where all employees are able to proactively contribute to patient safety.

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Conclusions

 

With dysfunctional communication patterns responsible for a considerable portion of adverse events in the hospital setting, effective CRM training in other high risk industries is gaining appeal. But change routinely meets with resistance. Strong leadership from the top levels of the organization has proven to be the key to effective implementation within Memorial. By concentrating on the successes garnered through a well implemented debrief and follow-up process, surgeons, anesthesia professionals, and staff are more likely to be open to the other aspects of the CRM Patient Safety System. By encouraging all members of the team to be fully involved in assuring the patient’s safety, hospitals can draw on the full capabilities of their team members to continually improve their practice. Memorial highly recommends this approach to creating a culture of patient safety.