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Crisis Resource Management

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The Comprehensive Textbook of Healthcare Simulation

Abstract

Crisis Resource Management (CRM) in health care, a term devised in the 1990s, can be summarized as articulation of the principles of individual and crew behavior in ordinary and crisis situations that focuses on the skills of dynamic decision-making, interpersonal behavior, and team management.

It is a system that makes optimum use of all available resources—equipment, procedures, and people—to promote patient safety. “Crisis” Resource Management, a form of training to improve airline safety, grew out of a number of concepts but was largely modeled on “Crew” Resource Management from US commercial aviation in the 1970s and 1980s. Since its earliest iterations, Crisis Resource Management has grown in health-care provision and education from individual disciplines and institutions to entire health-care systems. Crisis Resource Management training programs come in many different formats with varying pedagogical underpinnings. Some didactic, some immersive, but the majority contain hybridized educational techniques in a variety of health-care settings. Conceptually, they all typical concentrate on a number of major categories: Team Management, Resources Allocation and Awareness of Environment, and Dynamic Decision-Making. Leadership, role clarity, workload and task distribution, and effective communication within teams are core concepts, as are seeking help, anticipation, and planning, in addition to using all available information, with a particular emphasis on cognitive aid and checklist usage. A number of rating systems for CRM have been developed to access CRM behaviors both in individuals and teams and across disciplines. Outcome measures of CRM training have produced missed results. CRM programs like any other educational endeavor do not exist in a vacuum but are subject to organizational and cultural influences that exist in any system. Ideally, CRM training programs, reinforced in the actual work environment, are just one part of a multifaceted strategy to improve teamwork, safety culture, and patient safety.

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Authors and Affiliations

  1. Department of Anesthesia, Stanford University School of Medicine, Stanford, CA, USA

    Ruth M. Fanning MB, MRCPI, FFARCSI, Sara N. Goldhaber-Fiebert MD & Ankeet D. Udani MD

  2. Department of Immersive and Simulation-Based Learning, Stanford University, Stanford, CA, USA

    David M. Gaba MD

  3. Department of Anesthesia, Simulation Center, VA Palo Alto Health Care System, Anesthesia Service, Palo Alto, CA, 1871, USA

    David M. Gaba MD

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  1. Ruth M. Fanning MB, MRCPI, FFARCSI
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Correspondence to Ruth M. Fanning MB, MRCPI, FFARCSI .

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Editors and Affiliations

  1. Departments of Anesthesiology Otolaryngology, and Structural & Chemical Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Adam I. Levine MD

  2. Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Samuel DeMaria Jr. MD , Andrew D. Schwartz MD  & Alan J. Sim MD ,  & 

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Fanning, R.M., Goldhaber-Fiebert, S.N., Udani, A.D., Gaba, D.M. (2013). Crisis Resource Management. In: Levine, A.I., DeMaria, S., Schwartz, A.D., Sim, A.J. (eds) The Comprehensive Textbook of Healthcare Simulation. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5993-4_8

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