Crisis Resource Management in emergency medical settings in Qatar

Abstract

The principles of Crisis Resource Management (CRM) aim to mitigate the risks associated with a potential crisis and improve patient safety. Effective teamwork and communication are key CRM elements in emergency care medicine. This article will explore their importance in the context of pre-hospital emergency care in Qatar, which is provided by the national Ambulance Service (HMCAS). The national and organizational environments are culturally very diverse which presents particular challenges that can impede the CRM principles, and 2 ultimately affect patient care. This is especially worrying if emergency care practitioners (EMC) are not forthcoming with their concerns and allow patients to be endangered. To partly counteract the individual cultural diversity within the organization, HMCAS recognized the importance of trying to inculcate a different organisational culture promoting an environment whereby practitioners can speak up, irrespective of culture, nationality, or the presence of more senior or experienced colleagues. To that effect CRM principles are a core element of the HMCAS EMC practitioners' orientation programme and continuing professional development (CPD) courses. Special emphasis is made on the key principles of teamwork and communication, and in relation to mutual support, feedback, and speaking up when concerns arise. Regular training involving all role players (including supervisors) in different settings, and appropriately simulated scenarios that call for application of CRM principles is required to further improve the quality of EMC service in Qatar.

Presence of a pre-hospital enhanced care team reduces on scene time and improves triage compliance for stab trauma

“…It seems likely that this, coupled with an increased exposure to these incidents, will mean they are better prepared for the challenges which victims of penetrating trauma provide. They also have increased training in the subject of CRM, the importance of which is becoming increasingly recognised in pre-hospital and high acuity care [24, 25]. In this way, these results would seem to support the position that an important benefit which an ECT brings to the penetrating trauma patient is scene/team management; an understanding of the importance of shorter scene times, and the driving force to help achieve them.…”

An Evaluation of Pre-Hospital Emergency Care Personnel Knowledge About Crisis Resource Management and Perspectives of Educators About Inclusion of Crisis Resource Management in the Pre-Hospital Emergency Care Curriculum

“… 12 Pre-hospital emergency care personnel are expected to possess knowledge, experience, and excellent judgement skills, so that they can make sound clinical decisions and function optimally and independently in an unstructured and constantly changing environment, such as the pre-hospital emergency care setting. 12 …”

“… 11 However, very little research has been done on CRM in the pre-hospital setting. 12 It has been suggested that CRM can reduce the incidence of clinical error and contribute to effective teamwork and the success of a pre-hospital emergency care plan when applied in combination with good clinical practice. 13 Rall et al report that an emergency care practitioner’s knowledge of and adherence to the principles of CRM can enhance patient safety during pre-hospital care.…”

Cost-Effective Extracorporeal Membrane Oxygenation Simulation

“…19,22,23 Hamad Medical Corporation is making great progress in terms of embedding various simulation modalities within its orientation training programs and courses, bringing up patient safety and CRM-related discussion topics during workshop presentations, team-based assignments, and debriefings with simulation participants. 24,25 The ultimate objective of these educational interventions is to encourage participants to reflect by considering the issues faced and their approach to tackling the situation.…”