Implementing Crew Resource Management within Perinatal Services: Integrating Many Voices to Accomplish One Mission

A Crew Resource Management (CRM) model was implemented within Perinatal Services to improve patient safety and optimize the quality and efficiency of patient care. This poster outlines the successful strategies employed by an academic, community, Magnet hospital to successfully incorporate CRM concepts, focusing on cooperation, coordination and, sharing, among disciplines involved in the care of perinatal patients. 

The implementation of CRM requires education and diligence by all staff members to utilize various concepts.  Concepts of CRM include: communication, situational awareness, problem solving, decision making and collaborative teamwork. The presenting organization translated these concepts into the following actions: selection of SBAR (Situation – Background – Assessment – Recommendation) as a consistent, interdisciplinary communication format; commitment to the two challenge rule; core team meetings; utilization of a rapid response team; and, collaborative team rounds. The collaborative team consists of labor and delivery clinical nursing staff; the charge nurse; obstetrical peri-operative team; 24 hour attending obstetrician; perinatologist; neonatologist; neonatal intensive care unit and mother baby unit nurses; anesthesiologist; nurse anesthetist and chief obstetrician.

Quantitative outcomes have included reduction of adverse outcome index and decrease in the incidence of birth trauma. Other benefits of CRM within the presenting institution are: decreased errors; improved patient safety; and, increased staff satisfaction.   

Involvement of CRM is more than just developing actions; it creates a new organizational environment that specifically defines behaviors for collaborative teams to follow.  To support this environment, nurses at this organization were educated to acknowledge risks, respond with firm strategies, and provide effective feedback to all members of the collaborative team.  The process of CRM developed by the presenting organization can be utilized by hospitals within any service line.  Nurses are empowered by CRM to use their many voices to provide optimal patient care.