The U.S. healthcare system is now spending many millions of
dollars to improve "patient safety" and "inter-professional
practice." Nevertheless, an estimated 100,000 patients still
succumb to preventable medical errors or infections every year. How
can health care providers reduce the terrible financial and human
toll of medical errors and injuries that harm rather than heal?
Beyond the Checklist argues that lives could be saved and
patient care enhanced by adapting the relevant lessons of aviation
safety and teamwork. In response to a series of human-error caused
crashes, the airline industry developed the system of job training
and information sharing known as Crew Resource Management (CRM).
Under the new industry-wide system of CRM, pilots, flight
attendants, and ground crews now communicate and cooperate in ways
that have greatly reduced the hazards of commercial air travel.
The coauthors of this book sought out the aviation professionals
who made this transformation possible. Beyond the Checklist gives
us an inside look at CRM training and shows how airline staff
interaction that once suffered from the same dysfunction that too
often undermines real teamwork in health care today has
dramatically improved. Drawing on the experience of doctors,
nurses, medical educators, and administrators, this book
demonstrates how CRM can be adapted, more widely and effectively,
to health care delivery.
The authors provide case studies of three institutions that have
successfully incorporated CRM-like principles into the fabric of
their clinical culture by embracing practices that promote common
patient safety knowledge and skills.They infuse this study with
their own diverse experience and collaborative spirit: Patrick
Mendenhall is a commercial airline pilot who teaches CRM; Suzanne
Gordon is a nationally known health care journalist, training
consultant, and speaker on issues related to nursing; and Bonnie
Blair O'Connor is an ethnographer and medical educator who has
spent more than two decades observing medical training and teamwork
from the inside.
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