Objectives

1
Introduction

• Chapter 1

2
Objectives

• Define crew resource management.
• Describe how to achieve collective situational
  awareness.
• Describe the humanware component.

3
Introduction (1 of 2)

• Questions asked after a major incident where a
  bad outcome causes an investigation
• Why dont 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?

4
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?

5
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.

6
By the Numbers (2 of 9)

• 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

7
By the Numbers (3 of 9)

• 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.

8
By the Numbers (4 of 9)

• 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

9
By the Numbers (5 of 9)

• 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
  19922002.

10
By the Numbers (6 of 9)

• 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.

11
By the Numbers (7 of 9)

• 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.

12
By the Numbers (8 of 9)

• 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

13
By the Numbers (9 of 9)

• Source Adapted from NFPA, Fire Analysis and
  Research Division, Fire Fighter Fatalities in the
  U.S., July 2009.

14
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

15
Humanware (2 of 7)
16
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

17
Humanware (4 of 7)

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

18
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

19
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.

20
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

21
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 members strengths

22
Preparing for CRM (2 of 3)

• 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

23
Preparing for CRM (3 of 3)
24
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.

25
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.