Implementation of crew resource management: A qualitative study in 3 intensive care units

Peter F. Kemper, Cathy Van Dyck, Cordula Wagner, Martine De Bruijne

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Objectives Classroom-based crew resource management (CRM) training has been increasingly applied in health care to improve safe patient care. Crew resource management aims to increase participants' understanding of how certain threats can develop as well as provides tools and skills to respond to such threats. Existing literature shows promising but inconclusive results that might be explained by the quality of the implementation. The present research systematically describes the implementation from the perspective of 3 trained intensive care units (ICUs). Methods The design of the study was built around 3 stages of implementation: (1) the preparation, (2) the actions after the CRM training, and (3) the plans for the future. To assess all stages in 3 Dutch ICUs, 12 semistructured interviews with implementation leaders were conducted, the End-of-Course Critique questionnaire was administered, and objective measurements consisting of the number and types of plans of action were reported. Results The results categorize initiatives that all 3 ICUs successfully launched, including the development of checklists, each using a different implementation strategy. All ICUs have taken several steps to sustain their approach for the foreseeable future. Three similarities between the units were seen at the start of the implementation: (1) acknowledgment of a performance gap in communication, (2) structural time allocated for CRM, and (3) a clear vision on how to implement CRM. Conclusions This study shows that CRM requires preparation and implementation, both of which require time and dedication. It is promising to note that all 3 ICUs have developed multiple quality improvement initiatives and aim to continue doing so.

Original languageEnglish
Pages (from-to)223-231
Number of pages9
JournalJournal of Patient Safety
Volume13
Issue number4
DOIs
Publication statusPublished - 1 Dec 2017

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Intensive Care Units
Anniversaries and Special Events
Quality Improvement
Checklist
Patient Care
Interviews
Delivery of Health Care
Research

Keywords

  • behavioral change
  • crew resource management
  • CRM = CREW RESOURCE MANAGEMENT
  • CUSP = COMPREHENSIVE UNIT-BASED SAFETY PROGRAM
  • ECC = END-OF-COURSE CRITIQUE
  • evaluation
  • IC = INTENSIVE CARE
  • ICU = INTENSIVE CARE UNIT
  • implementation
  • implementation leaders
  • intensive care unit
  • Key Words/Abbreviations
  • medical team training
  • patient safety
  • quality improvement

Cite this

Kemper, Peter F. ; Van Dyck, Cathy ; Wagner, Cordula ; De Bruijne, Martine. / Implementation of crew resource management : A qualitative study in 3 intensive care units. In: Journal of Patient Safety. 2017 ; Vol. 13, No. 4. pp. 223-231.
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Implementation of crew resource management : A qualitative study in 3 intensive care units. / Kemper, Peter F.; Van Dyck, Cathy; Wagner, Cordula; De Bruijne, Martine.

In: Journal of Patient Safety, Vol. 13, No. 4, 01.12.2017, p. 223-231.

Research output: Contribution to JournalArticleAcademicpeer-review

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