Introduction

Introduction

Chapter 1

Objectives

• Define crew resource management.

• Describe how to achieve collective situational awareness.

• Describe the humanware component.

Introduction (1 of 2)

• Questions asked after a major incident where a bad outcome causes an investigation:– Why don’t team members speak up when

they perceive something differently from how a group of their peers do?

– What are the effects of a hierarchical system on team performance?

Introduction (2 of 2)

• Questions (continued):– How can barriers be broken down to

achieve collective situational awareness during critical events?

– How do veterans operate and perceive their surroundings differently from the way novices do?

– What are the internal cultural barriers that impede optimal team performance?

By the Numbers (1 of 9)

• One strategy integrated into emergency service team performance has been CRM. – First developed and implemented by

commercial airlines– Many agencies and organizations have

attempted to implement programs that rely on CRM principles.


• Of the 11 agencies that received CRM training, only 3 were effectively using CRM after two years.– Lack of commitment by leadership– Lack of follow-up training– Failure to implement nonpunitive methods

for dealing with accidents, errors, and members who spoke openly about concerns


• U.S. fire service experiences 100 line-of-duty deaths and 100,000 lost-time injuries per year. – Line-of-duty death: fatality to an emergency

worker during the course of responding to, training for, or providing service to the public

– Evolution of firefighting tactics means fire fighters are less likely to be killed and injured by flames, smoke, or heat.


• NIOSH fire fighter line-of-duty death reports list these contributing factors:– Communication failure– Poor decision making– Lack of situational awareness– Poor task allocation– Leadership failures


• EMS errors made in patient care could be contained by implementing CRM techniques in high-risk, low-frequency procedures conducted in the field. – The number of medications on EMS vehicles

is getting more attention. – U.S. FDA received 20,000 reports of

medication errors (prehospital and in-hospital) from 1992–2002.


• Extremes of fire behavior in wildland/urban interface make CRM more valuable.– Buildup of natural fuels, scant controlled

mitigation of fire risks, and characteristics of communities lead to situations requiring critical interagency cooperation and communication.

– CRM can be effective in overcoming the changing environment.


• The aeromedical industry is still one of the most dangerous professions. – The rate of helicopter crashes is alarming.– Cost-benefit ratio and medical necessity of

evacuation by helicopter is still debated.– Safe practices should be universal. – Pilots say the largest barrier to safety is lack

of commitment by administrators to provide ongoing training and education.


• When the U.S. Coast Guard applied CRM to its air operations, crashes and accidents were reduced by 70 percent.

• Safety is a human issue affected by:– Cultural change– Error trapping– Ensured high reliability


Source: Adapted from NFPA, Fire Analysis and Research Division,

Fire Fighter Fatalities in the U.S., July 2009.

Humanware (1 of 7)

• Define the issue and deploy “humanware,” software, and hardware to solve the problem. – “Software” implementation: rewriting training

manuals or operating guidelines– “Hardware” solutions: building construction

modifications– Humanware: people who are part of a team

directed to solve a problem

Humanware (2 of 7)

Humanware (3 of 7)

• ICS is used in managing emergency incidents to help identify incident needs and priorities.– ICS lets leaders and managers deploy

resources in a structured, objective manner by:• Identifying roles and responsibilities• Outlining clear lines of communication• Limiting span of control• Providing methods for expanding the incident

Humanware (4 of 7)

• Some incidents used an outstanding ICS structure, but injury or death occurred because of poor:– Resource allocation– Communication– Incident management

Humanware (5 of 7)

• CRM provides behavioral expectations for the humanware involved in the incident. – Highlights areas where team communication

breaks down by:• Seeking input

• Acknowledging communication

• Respectfully providing differing opinions

• Resolving conflict

• Monitoring a decision

Humanware (6 of 7)

• Implementing CRM provides a safer environment in the field and results in team members having a greater understanding of mission goals and objectives.

• CRM helps get maximum and safe performance from all personnel.

Humanware (7 of 7)

• Synergistic situational awareness is possible if all team members understand:– The mission– The dangers– Their strengths and weaknesses– Their role in team communications

Preparing for CRM (1 of 3)

• CRM concepts are embraced when they are introduced.

• CRM requires:– Open and honest communication– Immediate analysis of alternate

probabilities– Reliance on each team member’s

strengths


• Once CRM is adopted, implementation is more difficult.

• Preparation includes training personnel in techniques of open communication:– A comprehensive approach to identifying

and tracking errors and mistakes– Conflict management training and education– Teaching the power of organizational stories


Summary (1 of 2)

• CRM requires open and honest communication, immediate analysis of alternate probabilities, and a reliance on the strengths that each team member intrinsically brings to the team.

Summary (2 of 2)

• Implementing the principles of CRM can provide a much safer environment in the field and will result in a greater understanding of the mission goals and objectives.

• An organization that has prepared its employees for CRM also has developed a strong foundation so that the CRM principles will thrive.

Documents

Introduction