Impact of CRM–Based Team Training on Obstetric Outcomes and Clinicians’ Patient Safety Attitudes

Medical error is a leading cause of adverse events and patient death. Further, poor communication is a leading cause of medical error. Team training based on Crew Resource Management (CRM) has been suggested as a way to improve communication among caregivers and thereby improve patient safety. However, little data exist demonstrating that CRM concepts can be integrated into clinical medicine or that they positively influence clinical outcomes. Grogan et al. demonstrated that an eight-hour didactic course on teamwork improved operating room staff attitudes toward teamwork. A similar model increased teamwork behaviors and decreased adverse events in the emergency department (ED). Thompson et al. found that getting intensive care unit clinicians to a multidisciplinary meeting every morning improved daily work flow. Improved perioperative communication has been associated with a decrease in wrong-side surgery and with shorter hospital stays. Multidisciplinary training in simulated obstetric emergencies has been associated with improved midwife and obstetrician knowledge and neonatal outcomes. Finally, the patient mortality rate decreased below predicted in cardiac surgical patients after the implementation of CRM–based teamwork training. In this article, we demonstrate how we have successfully developed, implemented, and sustained a CRM–based team training process on our obstetrics unit and how this teamwork has had a positive effect both on the attitudes of our staff towards patient safety and on patient outcomes.