Cr Crisis R Res esource e Manag agem ement i in Aviation on - PowerPoint PPT Presentation

Cr Crisis R Res esource e Manag agem ement i in Aviation on a and H Hea ealthcar are

Fernando Salvetti - J.D., P.P.E., M.Phil., Ph.D. Centro Studi Logos, Turin, Italy Logosnet, Lugano, Switzerland and Houston, TX, USA Roxane Gardner - M.D., M.H.P.E., M.P.H., Ph.D. Crisis Cr Center for Medical Simulation, Boston, MA, USA Brigham and Women’s Hospital / Children's Hospital / Massachusetts General Reso esource e Hospital and Harvard Medical School, Boston, MA, USA Manag agem ement Rebecca Minehart - M.D., M.S.H.P.Ed. Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA in A n Avi viation Center for Medical Simulation, Boston, MA, USA and He Heal althcar are Cristiano Galli - B.Sc., MSc Aviation, M.IA Global Aerospace Logistics / Air Defense Institute of the Emirates Air Force, Abu Dhabi, UAE Barbara Bertagni - B.Sc., B.A., M.A., M.Phil., Ph.D., Clin.Psy.D. Centro Studi Logos, Turin, Italy Logosnet, Lugano, Switzerland and Houston, TX, USA

Simulation on – both i in aviation on and i in hea ealthcare – contributes es en enormousl sly t to enh enhancing teamwork rk d duri ring a a cri crisi sis, a , as s well a as foster ering situation onal awaren enes ess, con ontextual intelligence, e, and cogn ognitive e retenti tion of es esse senti tial s step eps a s and procedures t s to be p be per erformed during c crisis. s.

Mod oder ern a aviation on c crisis resou ource m e manag agem emen ent focuse ses o s on speci ecifi fic skills a and com ompeten encies es a areas: com ommunication on, s situation onal al awaren enes ess, decision on m making, problem em s solving, t teamwor ork k and l lea eadersh ship. Steps t to o fol ollow in a abnor ormal s situation ons

Until 1977, an Aircraft Com ommander er wa was res espon onsible fo for almost all deci ecision ions in non- sta tandard situations. Crew an and Cockpit Res esou ource ce Management training ng em emer erged afte ter the he rec ecognition on that the technical al skills of of piloting an aircraft we were insuffici icien ent to en ensure safet ety an and best per erfor ormance ce: acc cciden ents we were oc occu curring fo for reason ons other than an inad adequate piloting skills. An An impor ortant innov ovative approa oach wa was intr trod oduced ced to assig ign cock ockpit roles oles that pos ositiv tively ely influenced team dynam amics. Once al aligned on on the runway and rea eady fo for take-off, f, new ew function onal roles oles are es established: PF and PM. PF stan ands ds fo for Pilot Flyi ying an and PM fo for Pilot ot Moni nitori ring ng. Thes ese fu function ctional roles are not ot rel elated ed to crew sen enior ority ty.

Al Also ca cabin crews ws are activ ctively ely involved in crisis management. Since ce the he 1980s, thes ese programs focu ocus on on “non-tech echnic ical” l” skills that are critical fo for en enhanced ed op oper erational per erfor ormance, ce, such ch as lea eader ership, situati tion on awaren enes ess, deci cision ion making, teamwor ork and co communica cation. Our hypoth othesis—cu curren ently under te test an and review—fo for enhan ancing teamwor ork is that sim imula lation within a setting based ed on on mixe xed, or or hybri rid, reality called led e-REAL allows ws fo for better res esults lts com ompared ed wi with those rea eached ed within the ot other er se settings availa lable le today, y, such ch as CAVE-like envi vironmen ents, virtual reality head-mo mounted disp splays, or or co compute ter based ed e-learn rning en envi vironmen ents ts.

Te Tests are expec ected ed to be per erfor ormed ed within the e-REAL immersive labs at the Polytechnic Sch chool ool of of Milan an and at the Univer ersity ty Marconi in Ro Rome. Te Tests will be focu cused ed on on tea eamwor ork, crisis management an and deci ecisio ion ma making. Startin ting Septem ember er 2020, the te tests per erfor ormed will be des esig igned ed as an es escape game within an e-REAL setting— in wh which a tea eam of of players co cooperative vely discovers clues es, solv olves es puzzles, an and acc ccomplishes tasks in or order t to o progress a and acc ccomplish a a speci ecific c goa oal in a a limited ed amou ount t o of time.

Effec ecti tive t e tea eamwork d during a cr crisis is also o a core el elem emen ent of t of expert p t practi ctice i ce in hea ealth thcare, w wher erei ein prof ofessionals a are e ch challen enged ed t to o rec ecognize a a situ tuati tion on th that t req equires es r rapid inter erventi tion, , communication, kn knowledge sh shar aring, deci ecision on-making a and managem emen ent o of unfor ores eseen en e even ents ts—all th the e while e also o taking into o con onsider erati tion cr criti tical con ontextu tual f fact ctors s such ch as a lack ck o of ti time, s e, scarci city ty of of res esou ource ces a and tool ools, , and a multi titu tude of e of i impactf tful l fact ctor ors. “Name-Cl Claim-Aim,” a a cr crisis managemen ent t organizati tional a approa oach ch th that t uses es a mnem emonic d devi vice, w ce, was developed a at CM CMS S in Boston an and is s bei eing used ed in or order er t to faci cilitate cr crisis managemen ent a t and d deci ecision m making. .

Kn Knowledge an and technical al skills are es essen entia tial componen ents of of the dec ecision on- making proc ocess an and action ctions per erfor ormed during cr crises, but they ey are not suffici icient to manage the entire situ tuati tion on, wh which includes the he en envir vironmen ent, the equipment and the pat atient care team wi with its organizational behavior. Theref efore, an “Even ent M t Manager er Check ecklist” w was cr crea eated ed t to o faci cilitate effectiv ective r e rol ole d e des esignati tion on. P . Parti tici cipants ts have b been given this s cognitive ai aid, desi signe ned as an as an I ID bad adge-sized ed c card, t , to ea easily acces ccess d during th thei eir simulati tion cou ourse.

The The ro role of of “Ev Event Manager er,” rath ther th than “Tea eam Lea eader er,” is is ex expressly pro romoted at at CMS MS to facilitate distribut buted lea eader ersh ship in crises ses. Thi his disti tincti tion has pro roven to be be ef effective ve in tea eams of of ex expert practi titioners bec ecause se it del eliber eratel ely see seeks to flatt tten hier erarchies es th that may oth therwise inhibit sp spea eakin ing-up up behav avior from te team me memb mbers. The The Ev Event Manager er coordinates the he communication and the he tea eam’s effort orts, over erseei seeing th the or organization on and applic licatio ion of of CRM RM principles, in in additi tion to acti tively soliciti ting input nput and nd dec ecisi sion- making re regard rding med edical ca care, if nec ecess essary. Moreover, th Mo the Event Manager er acts to facilitate ro role designati tion, as we well as orchestrate an and coor oordin inate te team functi tion. A few ye years ago, the he “Name me-Cla laim im-Aim” m” and nd “Ev Event Manager Ch Checkli klist” we were re adopte ted by th the Massa sachuse setts Gen ener eral Hosp spital in Bos Boston on, fo for inclusion in th the lat atest ver ersi sion of of the heir Emerg rgency Man anuals ls.

e-REA EAL allo llows fo for bett tter res esults fo for lea earning how to use a mn mnemo monic like ke “Name me-Cla laim im- Aim”, ”, th that en enab ables a multi tilayer vi visi sion. The The many ny le levels ls of of th the situ tuati tion are re ma made availa ilable le si simultaneo eousl sly by over erlaying multi tisource info fo—e.g. wo words, num numbers, images, es, etc tc.— sim imila ilar to to an au augmen ented rea eality disp splay, but but witho hout ut needi ding ng to to wear ear sp spec ecia ial glasses ses. e-REA EAL impro roves th the lea earners’ s’ cogniti tive retent ntion by making the he rela latio ionship ips betwe ween topics vi visual, wh which ch yiel elds bett tter resu esults compared ed wi with those from the other er systems. e-RE REAL o offers a unique u user experience: a a combination of visual c communicati tion a and direct t interacti tion wi with the c content—by gestur ure o or spoken c n commands ds—that i imme mmerses pe people e in a n an e n entirel ely inter eractive e e ecosystem em.