Former Pilot Describes Crew Resource Management for Nurses
September 26, 2012 | Strategic Insights for Health System
When Gary L. Sculli, M.S.N., ATP, was laid off from being a pilot with a major U.S. airline and returned to his former career of nursing, “I was in culture shock,” he said. Now director of clinical training programs for the Veterans Health Administration’s (VHA) National Center for Patient Safety, Sculli presented “Nursing Crew Resource Management: High-Reliability Behaviors for Front-Line Nurses,” on Friday, September 21, 2012, at the National Association for Healthcare Quality’s annual conference in Tampa. He described how VHA developed a unit-based crew resource management (CRM) program for nurses. Aviation uses team training, human factors awareness, a high degree of standardization, briefings, checklists, incentivized nonpunitive reporting, “perpetual” training, and simulation. “Pilots will never say, ‘Do I have to use the checklist?’” Sculli said. By contrast, nursing has hierarchical relationships, no emphasis on human factors, varying degrees of standardization, and fear and shame in error reporting. In addition, more focus on systems thinking is needed. Everyone attending Sculli’s talk had seen the Swiss cheese model before, but, said Sculli, frontline nurses have not.