Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety

Overview

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...

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Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety

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Overview

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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Editorial Reviews

From the Publisher
"Some experts downplay the parallels between health care and aviation, but there is much we can learn from the system-wide change that greatly improved passenger safety on commercial airlines. This excellent book highlights the innovative programs of pioneering hospitals where better teamwork and effective communication guide every interaction—from the bedside to the boardroom."—Julia Hallisy, DDS, The Empowered Patient Coalition

"This important book brings both a sense of urgency and the hope of clarity in addressing a fundamental and widespread problem in health care. It is a must-read for clinicians and students who deliver care and a call for leadership from every member of the interprofessional team. Leadership is required to change the culture and systems of care delivery. Beyond the Checklist provides the inspiration and a path for that change."—Heather M. Young, RN, FAAN, Betty Irene Moore School of Nursing, University of California, Davis

"Beyond the Checklist shows us that Crew Resource Management principles help us deal with our human inability to always perform 'perfectly' while operating in a complex work environment. Little mistakes in aviation compound into huge problems. In commercial airlines, virtual strangers routinely solve complex problems without making critical mistakes. The culture of CRM provides for this as a normal way of operation. If embraced by the field of medicine, it will totally transform the way the industry operates."—Captain Gregory S. Novotny

Library Journal
Using the principles learned in the aviation industry through a program called Crew Resource Management, Gordon (When Chicken Soup Isn’t Enough: Stories of Nurses Standing Up for Themselves, Their Patients, and Their Profession) and her coauthors propose that this plan also be used for hospitals and medical staff. They write about how the airline industry has successfully cut down on disasters by using input from all personnel and getting them to work better as teams. Much time is spent explaining how the airline industry does that and how it has improved its safety records. They write about the training methods used and the airlines rules to make pilots and others comply. Unfortunately, because more than three-quarters of this book is spent on the airlines, not much is written about what suggestions would allow this plan to be implemented in medical situations. Nor do they spend much time writing about how they would propose that physicians be incorporated into the actual plan or induced to comply with the procedures.

Verdict Readers who are interested in aviation industry safety information would find this book challenging, but there is not much concrete medical safety information here.—Karen Sutherland, White Oak Lib. Dist., Romeoville, IL

(c) Copyright 2013. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.

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Product Details

Meet the Author

Suzanne Gordon is coeditor of the Cornell University Press series, The Culture and Politics of Health Care Work, and was program leader of the Robert Wood Johnson-funded Nurse Manager in Action Program.

Patrick Mendenhall is a Principal in Crew Resource Management LLC who is a pilot for a major commercial airline and belongs to the Air Line Pilots Association.

Bonnie Blair O'Connor is Professor of Pediatrics (Clinical) and Associate Director, Pediatric Residency, at Hasbro Children’s Hospital/Alpert Medical School at Brown University in Providence, R.I.

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Table of Contents

Foreword by Captain Chesley "Sully" Sullenberger

Introduction
1 History of Crew Resource Management
2 Communication
3 Case Study: Maimonides Medical Center
4 Team Building
5 Case Study: Osher Clinical Center for Complementary and Integrative Medical Therapies
6 Workload Management
7 Case Study: Interprofessional Education and Practice at the University of Toronto
8 Threat and Error Management
9 Why CRM Worked
10 The Problems in Medicine
11 Conclusion

Appendix: Maimonides Medical Center Code of Mutual Respect

Glossary
Notes
Index

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