Fundamental Concepts

Crew Resource Management (CRM)

Crew Resource Management (CRM) has filtered its way from the aviation industry, to the healthcare professions, and finally to prehospital emergency medicine. CRM took off after a series of tragic aircraft mishaps as a team-oriented approach to reducing errors in complex environments.

Operational Medicine (EMS, tactical medicine, and other forms of delivering care) is a prime environment for errors due to a whole constellation of human factors. Long hours, sleep deprivation, and dangerous, dark, noisy environments. Our patients may have complex complaints. We may need to do rapid detailed sequential procedures. This all leads to increased cognitive load, task saturation, and error.

This CRM chart is adapted from the Army’s older Aircrew Coordination Training (ACT) program. The manual goes into much greater detail about the components and how they interact to ensure the whole crew is operating efficiently to achieve complex missions. I recommend giving it a read if you can.

⏳ Timely & Effective Communication requires that statements and directives are clear, timely, relevant, complete, and verified (positive two-way confirmation)

🙌 Ready & Prompt Assistance means being prepared to offer help quickly by paying attention to what is going on and anticipating the sequence of events.

⚙ Coordinate Actions & Events means prioritizing actions and balancing workloads.

👀 Situational Awareness means keeping each other informed about the information you collect regarding the call and the environment.

There is more to it and this iceberg goes deep. Ask questions and do research. Small changes in behavior can produce big results when it comes to safety and good patient outcomes.

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