Sunday night I was participating in our weekly Google Hangout and conversation about interaction with mutual aid departments operating on our scenes evolved into a brief discussion on crew resource management (CRM). While many of you may already understand the concept, it is more than just something we use in emergency situations; the basics of crew resource management have day-to-day implications for the improvement of our work product as well as in maintaining a safe environment.
According to LeSage, Dyar and Evans in Crew Resource Management: Principles and Practice, crew resource management was first developed by commercial airlines as a result of study into how teams communicate, or more appropriately, how they communicated ineffectively during chaos. The examination of many airline disasters found similar aspects in how firefighters die in the line of duty. Poor communication, ill-advised decisions, lack of situational awareness, inappropriate resource allocation, and leadership failure are cited in any number of NIOSH LODD studies.
Our involvement in high-risk, low-frequency events (like structure fires, advanced airway maneuvers, technical rescue, and so on) place us in harm’s way not just because of the nature of the event, but in how we react to the event or miss cues that would prompt us to take more appropriate action.
The communication techniques espoused in CRM received a fair amount of promotion in recent years. However, it is apparent to me that the concept by some is considered to be applicable in only certain circumstances, when in fact, almost anything we do could be made more collaborative. The whole concept actually goes to the heart of Deming's zero defects philosophy. CRM doesn’t just lend to a safer environment; it promotes a higher degree of accuracy. By letting go of the need to always be “in charge” and allowing the people we work with to provide appropriate input into the job at hand, we can create trust and synergy that can benefit not just the patient or the victim, but create less stress on our own people.
I can’t provide for you anything that you can’t read in the text, but what I can do is share some of the basics with you in order to promote a concept we should all be utilizing. As you will see over the next few days, a lot of what I already share with you in regard to leading is very much a part of crew resource management, and is thus a best practice we can use regularly, so that when we really need it in an emergency, we are already comfortable with the way we talk and listen to one another.