Safety Culture by CRM Training: Experiences from 2 Trainings in German Hospitals.

Abstract

Anaesthesia CRM training is in most cases performed at special simulation centres. This has the disadvantage that the participants act in an unknown environment with often unknown equipment. Our group – the simulation centre Mainz – has been invited by two German hospitals to perform a one week training of all team members (physicians and nurses) onsite. We used the METI HPS for training. The simulator was setup in an OR that was reserved for the training. Additional rooms included a seminar room and a debriefing room. The anaesthesia members were divided into groups of two physicians and two nurses and underwent a total of five scenarios with immediate video debriefing (Duration 1 hour). Theoretical aspects of human factors were added as lectures. Two groups of participants per day were trained alternatively. The scenarios consisted of relevant anaesthesia complications. RESULTS: During the week including the Saturday we trained a total of 60 persons from each of the clinics. That is about 25 % in the first clinic (a university clinic) and about 40% of the total staff in the second (community hospital). After the training more than 95 % of the participants were very well satisfied with the training day and stated that this should be repeated regularly, e.g. in two year intervals. The university clinic invited us to do the training although they own an ECS simulator themselves. They decided to do this, because an external evaluation of the staff was considered more objective than if they had been using their own simulation group. Although it is difficult to prove the effects of such CRM training there was face validity that the training resulted in immediate behaviour changes, e.g. in terms of communication culture or that participants called for help more early. Concrete results included the decision of the team in modifying certain procedures to be more safe and / or more efficient.