CREW RESOURCE MANAGEMENT IN MEDICAL SCIENCES

Patient safety has become an increasingly important topic of discussion in health care organizations all over the world. The publication of the report "To err is human" by the Institute of Medicine in the United States triggered awareness of the importance of safer practices in health care, among both health care professionals and the public. The aviation industry shares many characteristics with medicine, particularly in terms of goal of risk reduction and importance of teamwork and interpersonal skills. The activities in a cockpit have been likened to those in an emergency room, operating room, and intensive care unit. Many authorities have suggested that some variant of team training is likely to be an effective means to reduce human en-or in operating rooms, emergency departments, resusicitation team and other settings within healtcare. Cockpit resource management is defined as management system that makes optimum use of all available resources, equipment, procedures and people to promote safety and efficiency. In the 1980's, the aviation industry began to implement a new type of nontechnical training, called cockpit resource management, which focused on human factors such as group dynamics, leadership, interpersonal communication and decision making. Over the past 10 years, lessons from aviation's approach to team training have been applied to patient safety, notably in intensive care unit and anesthesia training. This article reviews the literature on Crew Resource Management, also known as Cockpit Resource Management, and describes adaptations of this training framework to medicine.