Literature DB >> 20026831

Can aviation-based team training elicit sustainable behavioral change?

Harry C Sax1, Patrick Browne, Raymond J Mayewski, Robert J Panzer, Kathleen C Hittner, Rebecca L Burke, Sandra Coletta.   

Abstract

OBJECTIVE: To quantify effects of aviation-based crew resource management training on patient safety-related behaviors and perceived personal empowerment.
DESIGN: Prospective study of checklist use, error self-reporting, and a 10-point safety empowerment survey after participation in a crew resource management training intervention.
SETTING: Seven hundred twenty-two-bed university hospital; 247-bed affiliated community hospital. PARTICIPANTS: There were 857 participants, the majority of whom were nurses (50%), followed by ancillary personnel (28%) and physicians (22%). MAIN OUTCOME MEASURES: Preoperative checklist use over time; number and type of entries on a Web-based incident reporting system; and measurement of degree of empowerment (1-5 scale) on a 10-point survey of safety attitudes and actions given prior to, immediately after, and a minimum of 2 months after training.
RESULTS: Since 2003, 10 courses trained 857 participants in multiple disciplines. Preoperative checklist use rose (75% in 2003, 86% in 2004, 94% in 2005, 98% in 2006, and 100% in 2007). Self-initiated reports increased from 709 per quarter in 2002 to 1481 per quarter in 2008. The percentage of reports related to environment as opposed to actual events increased from 15.9% prior to training to 20.3% subsequently (P < .01). Perceived self-empowerment, creating a culture of safety, rose by an average of 0.5 point in all 10 realms immediately posttraining (mean [SD] rating, 3.0 [0.07] vs 3.5 [0.05]; P < .05). This was maintained after a minimum of 2 months. There was a trend toward a hierarchical effect with participants less comfortable confronting incompetence in a physician (mean [SD] rating, 3.1 [0.8]) than in nurses or technicians (mean [SD] rating, 3.4 [0.7] for both) (P>.05).
CONCLUSIONS: Crew resource management programs can influence personal behaviors and empowerment. Effects may take years to be ingrained into the culture.

Entities:  

Mesh:

Year:  2009        PMID: 20026831     DOI: 10.1001/archsurg.2009.207

Source DB:  PubMed          Journal:  Arch Surg        ISSN: 0004-0010


  8 in total

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Review 6.  What Do We Really Know About Crew Resource Management in Healthcare?: An Umbrella Review on Crew Resource Management and Its Effectiveness.

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  8 in total

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