Effects of Crew Resource Management Training (CRM) on Perceptions of Teamwork and Safety Climate of Perinatal Caregivers

Thursday, 25 July 2013: 1:55 PM

Wendy C. Budin, PhD, RN-BC, FAAN1
Susan Gennaro, RN, DSN, FAAN2
Flavia Contratti, MA, RNC-OB, LCCE, CLC1
(1)NYU Langone Medical Center, New York, NY
(2)Nursing, Boston College, Chestnut Hill, MA

Learning Objective 1: Describe changes in perinatal caregiver perceptions of teamwork and safety climate after implementation of a comprehensive 6-month Crew Resource Management (CRM) training program

Learning Objective 2: Compare perinatal nurse and physician perceptions of teamwork and safety climate

Purpose: As a result of the Institute of Medicine’s landmark findings on patient safety problems in U.S. hospitals (IOM, 1999), many organizations have implemented strategies to improve teamwork to ultimately improve patient safety. Patient safety climate which encompasses staffing, team respect, comfort with reporting errors, fostering appropriate feedback and open receptive communication, is an important factor in improving care in perinatal units. Purpose: to describe changes in perinatal caregiver perceptions of teamwork and safety climate after implementation of a comprehensive 6-month interdisciplinary Crew Resource Management (CRM) training program at a large urban academic medical center and to compare responses between nurses and physicians.

Methods:  Data were collected from nurses (n=70, T1; n=58, T2), and physicians (n=88, T1; n=46, T2) working in perinatal units at a large urban academic medical center in the north-east, of the USA. A pre-post comparative design was used. Prior to (T1) and one year after the initiation (T2) of the CRM training program, the Teamwork and Safety Climate Survey(Sexton, et al., 2006) was administered. This 27-item tool uses a 5- point Likert scale. Demographic information was also assessed.

Results:  There were significant improvements in nurses' perceptions of teamwork (t = -5.38, p =.000) and safety climate (t = -7.53, p = .000). Physicians also showed a significant improvement for teamwork (t = -7.43, p = .000) and safety climate (t = -6.69, p = .000). Pre-intervention, physicians perceived teamwork  to be significantly more positive (3.65, SD=.59) than nurses (3.22, SD = .57) (t = 4.62, p = .000). There were no significant nurse/physician differences between safety climate or post intervention perceptions of teamwork.

Conclusion: Findings support the benefit of team training to enhance perinatal caregivers’ attitudes towards teamwork and safety which may ultimately improve patient care.