Crew Resource Management Presentation Prepared for: Date: 2009

Crew Resource Management

Presentation Prepared for:

Date: 2009

www.firefighternearmiss.com

What is Crew Resource Management

Crew Resource Management (CRM) is an effective us of “all” resources to minimize errors and improve safety and performance.

1 Fatalit

y

10 lost time injuries

1000 No Loss Accidents

10,000 UNSAFE ACTS!

1000 No Loss Accidents

10,000 UNSAFE ACTS!



Crew Resource Management evolved from what was initially, “Cockpit Resource Management”.


Crew Resource ManagementA landmark event was United Airlines flight 173, which occurred in 1978. Flight 173 crashed in a wooded area outside of Portland. The problem which occurred involved an indicator light for the landing gear. It indicated that the landing gear was not completely down. The pilot was informed of a low fuel by his crew after he decided to fly around trying to figure out the light. He either disregarded them or misunderstood them and crashed killing 8 passengers and two crew members. Twenty three other people were seriously injured.

Why were so few killed?


Lack of Crew Resource Management

July 1, 1988, Hackensack, N.J., - Catastrophic collapse of bowstring trusses. The I.C. was scene with portable over shoulder participating in firefighting. Three (3) firefighters killed in initial collapse, two entombed that ran out of air. After 27 calls for help radio goes silent.

October 27, 1997, Washington D.C., - Fire in a corner grocery store. Crews initiated an aggressive interior attack. Crews evacuated after rapid heat build up and floor shift. Engine 14 exits crew can’t find officer. Crew reports their officer missing on two separate occasions to other officers. Dead officer of Engine14 found in basement.



From 1997 to 2001 –

500 firefighters died in structure fires and fire fighting operations.

Worcester, Mass. Keokuk, Iowa Louisville, Ky. New York City



Factors that contributed to these and other fire service tragedies are remarkably similar to factors identified by an industry that began adopting CRM as a mantra more than 25 years ago.

The nation’s aviation industry recognized that human error was the prevailing cause in aviation disasters.

The lessons learned by this industry are worth study by the fire service because of common contributing factors to the deaths in both industries.



CRM exists when all members of the team actively seek to

prevent adverse effects on the current situations.


Does the Fire Service Promote a Risk Culture?

Managing risk is our business, we do a great job taking care of Mr. & Mrs. Smith’s risk, but how about our own?

Human behavior patterns suggest that the well intentioned, best trained, consistently performing individuals and groups commit errors. (Titanic)

Accidents are not random occurrences – People cause accidents and make errors.

CRM has a proven history in reduction of errors.

Aviations, Military, and Medical.



Adrenaline and testosterone contribute to more injuries than structural failure. A key factor in firefighter injury or death is the risk a firefighter will take and their supervisor’s ability to control it.


How Does It Work?

Six PrinciplesCommunicationDecision-MakingTask AllocationTeamworkS/ADebrief*


Communication

Barriers and bias block effective communication

Standard language benefits all Practice “active” listening Divide duties to prevent overload Minimize distractions Establish Inquiry/Advocacy patterns

Clear, Concise Respectful Bishop’s Assertive Statement


Communication


Decision Making

Axioms Recognize problems Fight the fire Treat the patient Maintain SA Accept input Make a decision


Task Allocations Know your limits Know your crew’s

limits Capitalize on

strengths Seek out “experts” “Eat the elephant

one bite at a time”


Teamwork

Leadership

Followership

Photo by Bob Bartosz, Camden Fire Department


Situational Awareness

Point where reality and perception collide

Reality always wins Beware of loss factors

Ambiguity Distraction Fixation Overload Complacency Unresolved discrepancy


Debrief Pre-Brief

Topic Decorum

Facilitate Analyze

Operations Human

Behaviors


For More Information

http://www.iafc.org/associations/4685/files/CRM%20Manual.pdf (downloadable manual)

Okray and Lubnau, Crew Resource Management for the Fire Service. Penwell Publishing



The National Fire Fighter Near-Miss Reporting System

4025 Fair Ridge DriveFairfax, Virginia 22033

Tel: 703 537 4848Fax: 703 273 0920



The project is administered by the International Association of Fire Chiefs (IAFC) in

consultation with the National Fire Fighter Near-Miss Reporting System Task Force. The

project is endorsed by IAFC, International Association of Fire Fighters and the Volunteer & Combination Officers Section of the IAFC.


Documents

Crew Resource Management Presentation Prepared for: Date: 2009