Every member of the team must be willing and able to make a stop-the-line assertive statement, communicate without error, and provide mutual support like an expert team.
Collierville, TN (PRWEB) August 11, 2013
Cutting edge health care executives are blending the principles of Crew Resource Management (CRM) used by airline flight crews with the Toyota Production System (TPS). TPS, known as "Lean" in health care circles, has been used for several years to improve complex patient care processes. Using Lean, hospital staffs learn to use many of the same techniques employed by autombile assembly-line workers to improve and standardize their daily work procedures. The scientific approach to process improvement drives out inefficiency and wasted motion and reduces costs. Hospitals have used Lean to ensure on-time surgical cases, flawless patient testing procedures, and medication accuracy.
Despite the impressive gains in productivity, hospital administrators have found the results of process improvement to be perishable. Improvements can be fleeting. Investigating why, they've found that new processes seldom survive a poor work culture that fosters a reluctance to hold one another accountable to adhere to a standard way of doing things. When leaders look the other way, workers drfit back to old habits.
To counter the resistance to change, hosptial administrators have begun implementing teamwork and communication training based on the airline system called CRM. The aviation-based program teaches workers how to speak up and hold one another acoutable to defined standards of performance. Airlines say it has transformed their safety record in the last 20 years.
LifeWings, a team of pilots, astronauts, physicians and process improvement experts trained by Toyota, is one of the first consultant companies to provide this blended approach to performance improvement for health care. "Hospital leaders learn very quickly that it doesn't matter how efficient these new standardized practices are, if staff don't, or won't, use them," states LifeWings CEO, Steve Harden. "To ensure accountability with new processes it is critical to change your culture through CRM training. Every member of the team must be willing and able to make a stop‐the‐line assertive statement, communicate without error, and provide mutual support like an expert team."
Using CRM and Lean, LifeWings implements standard handoffs, checklists, treatment protocols, and communication scripts, to create high performing, accountable hospitals. High reliability orgnaizations who use both Lean and CRM are characterized by these six principles:
1. Protocols are known and used by all staff and regularly monitored for compliance; each unit has predefined, standardized assessments and order sets for all critical pathways.
2. Protocols exist for all patients, are known and used by all clinical staff and are regularly followed up through some form of monitoring or oversight. Staff are trained to use stop-the-line assertion, cross-check, and mutual support to ensure peer accountability to use protocols.
3. Inter-area protocols are known and used by all staff and regularly followed up; handoff information is documented; communication is interactive; and contingency plans are in place.
4. Physicians' and nurses' communication is interactive, and input occurs across work domains; multiple channels exist for soliciting concerns. Communication and collaboration skills are purposefully trained using CRM.
5. Multiple means are in place to capture patient and family concerns; systems are in place to capture and respond to positive and negative feedback. Peer-to-peer and team-based performance feedback (debriefing) is a routine behavior.
6. Protocols and discharge order sets exist for all patients, including, for example, a formal plan for handoffs between hospital and primary care physician - thus hardwiring effective communication between care givers; medication reconciliation plans are in place and monitored.
About LifeWings Partners LLC:
LifeWings Partners was founded by a former U.S. Navy Top Gun instructor, a commercial airline pilot, and two physicians who are former NASA astronauts. LifeWings’ practical and effective teamwork training programs are highly effective in reducing human error and currently involve the training of more than 13,000 high-performance medical team members per year. Measurable results are found in all LifeWings’ initiatives. To find out more, please visit http://www.saferpatients.com or https://www.facebook.com/LifeWingsSaferPatients