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Communication in Crisis: The Importance of ‘Verbal Dexterity’

  • P. G. Brindley

Abstract

Human factors are the number-one reason for commercial jet planes to crash. Furthermore, of all possible human factors, communication is the number one offender [1, 2, 3]. Evidence suggests exactly the same for acute care medicine [4, 5, 6, 7, 8, 9, 10, 11, 12]. However, in contrast to aviation, medical curricula focus on factual knowledge and procedural dexterity but rarely address ingrained culture or its effect upon communication [4, 5, 6, 7, 8, 9, 10, 11]. The airline industry felt compelled, as lives, and profits, were at stake [2]. With medical errors believed to cause almost 100,000 deaths annually in the USA, and representing the eight leading cause of preventable death [13, 14], we ought to be similarly motivated. This chapter hopes to offer practical strategies so that our (verbal dexterity' can match our procedural dexterity. This will be done primarily by translating lessons from the flight deck to the bedside. After all, if other high-risk industries such as aviation can do so, then at least as much should be expected of acute care medicine.

Keywords

Crisis Management Airline Industry Crew Resource Management Plane Crash Crisis Resource Management 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Rall M, Dieckmann P (2005) Crisis resource management to improve patient safety. Euroanesthesia 2005. Available at: www.euroanesthesia.org/Education/~/media/Filesl…/17rc l.ashx. Accessed Dec 2009Google Scholar
  2. 2.
    Gladwell M (2008) The ethnic theory of plane crashes. In: Outliers. Little, Brown and Company, New York, pp 177–223.Google Scholar
  3. 3.
    The New York Times (October 1st, 2007) Fatal airline crashes drop 65 0/0. Available at: http://www.nytimes.com/200711010 I/businesslO Isafety.html. Accessed Dec 2009Google Scholar
  4. 4.
    Pronovost P, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C (2003) Improving communication in the ICU using daily goals. J Crit Care 18: 71–75CrossRefPubMedGoogle Scholar
  5. 5.
    Sutcliffe K, Lewton E, Rosenthal M (2004) Communication failures: An insidious contributor to medical mishaps. Acad Med 79: 186–194CrossRefPubMedGoogle Scholar
  6. 6.
    Gawande AA, Zinner MJ, Studdert DM, Brennan TA (2003) Analysis of errors reported by surgeons at three teaching hospitals. Surgery 133: 614–621CrossRefPubMedGoogle Scholar
  7. 7.
    Knaus WA, Draper EA, Wagner DP, Zimmerman J (1986) An evaluation of outcomes from intensive care in major medical centers. Ann Intern Med 104: 410–418PubMedGoogle Scholar
  8. 8.
    Alvarez G, Coiera E (2006) Interdisciplinary communication: an uncharted source of medical error? J Crit Care 21: 236–242CrossRefPubMedGoogle Scholar
  9. 9.
    Devita MA, Schafer J, Lutz J Dongilli T, Wang H (2004) Improving medical crisis team performance. Crit Care Med 32: S61–65CrossRefPubMedGoogle Scholar
  10. 10.
    Gaba DM, Fish KJ, Howard SK (1994) Crisis Management in Anesthesiology. New York, Churchill LivingstoneGoogle Scholar
  11. 11.
    Gaba DM (1992) Dynamic decision-making in anesthesiology: cognitive models and training approaches. In: Evans DA, Patel VI (eds) Advanced Models of Cognition for Medical Training and Practice. Sprinter-Verlag, Berlin, pp 123–147Google Scholar
  12. 12.
    St Pierre M, Hofinger G, Buerschaper C (2008) Crisis Management in Acute Care Settings: Human Factors and Team Psychology in a High Stakes Environment. Springer, New YorkGoogle Scholar
  13. 13.
    Kohn LT, Corrigan J, Donaldson MS (2000) To Err is Human: Building a Safer Health System. National Academy Press, WashingtonGoogle Scholar
  14. 14.
    Baker GR, Norton PG, Flintoft V, et al (2004) The Canadian Adverse Events study: the incidence of adverse events among hospital patients in Canada. Can Med Assoc J 170: 1678–1686CrossRefGoogle Scholar
  15. 15.
    Royal College of Physicians and Surgeons of Canada (2008) CanMEDS framework. Available at http://rcpsc.medical.org/canmeds/index.php. Accessed Dec 2009Google Scholar
  16. 16.
    Davis D, O'Brien MA, Freemantle N, Wolf FM, Mazmanian P, Taylor-Vaisey A (1999) Impact of formal continuing medical education: Do conferences, workshops, rounds and other traditional education activities changes physician behavior or health care outcomes. JAMA 282: 867–874CrossRefPubMedGoogle Scholar
  17. 17.
    Helmreich RL, Merritt A (2000) Culture in the cockpit: Do Hofstede’s dimensions replicate. J Cross-Culture Psych 31: 283–301CrossRefGoogle Scholar
  18. 18.
    Helmreich RI (1994) Anatomy of a system accident: the crash of Avianca Flight 052. Int J Aviation Psych 4: 265–284CrossRefGoogle Scholar
  19. 19.
    Sohn HM (1993) Intercultural communication in cognitive values: Americans and Koreans. Language and Linguistics 9: 93–136Google Scholar
  20. 20.
    Dunn E.J, Mills, P.D. Neily J, Crittenden MD, Carmack AL, Bagian JP (2007) Medical team training: Applying crew resource management in the Veterans Health Administration. It Comm J Qual Patient Saf 33: 317–325Google Scholar
  21. 21.
    Kim J, Neilipovitz D, Cardinal P, Chiu M, Clinch J (2006) A pilot study using high-fidelity simulation to formally evaluate performance in the resuscitation of critically ill patients: The University of Ottawa Critical Care Medicine, High-Fidelity Simulation, and Crisis Resource Management. Crit Care Med 34: 2167–2174CrossRefPubMedGoogle Scholar
  22. 22.
    SBAR Institute for Healthcare Improvement (2009). SBAR technique for communication: a situational briefing model. Available at: http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGenerallTools/ SBARTechniqueforCommunicationASituationalBriefingModel.htm. Accessed Dec 2009Google Scholar
  23. 23.
    Brindley PG (2007) Novel technique for critical care training. Can Med Assoc J 176: 68CrossRefGoogle Scholar
  24. 24.
    Airbus Flight operations briefing notes (2009) Human performance: Managing interruptions and distractions. Available at: http://www.skybrary.aero/bookshelf/books/176.pdf. Accessed Dec 2009Google Scholar
  25. 25.
    Brindley PG, Hudson D, Lord JA (2008) The blindfolded learner: A simple intervention to improve crisis resource management skills. J Crit Care 23: 253–254CrossRefPubMedGoogle Scholar
  26. 26.
    Aron D, Headrick L (2002) Educating physicians prepared to improve care and safety is no accident: it requires a systematic approach. Qual Saf Health Care 11: 168–173CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science + Business Media Inc. 2010

Authors and Affiliations

  • P. G. Brindley
    • 1
  1. 1.Division of Critical Care Medicine4H1.22 University of Alberta HospitalEdmontonCanada

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