Crew Resource Management - Essay Example

? Crew Resource Management of the of the Crew resource management Introduction Crew resource management is a uniformproduct comprising of procedures of training used in the devastating environments caused by human errors. It is also termed as cockpit resource management as it is employed for the improvement of air safety (Kanki, 2010). Crew resource management primarily focuses on leadership, communication and decision making process. The training concepts of Crew resource management have been subjected to modification over the years due its wide applicability in the decision making process at critical situations such as in the field of aviation (Salas, 2006). Other arenas where Crew resource management is useful include ship handling, medical operation theatres, fire fighting and most importantly air traffic control (Dunn, 2007). Apart from cockpit resource management, Crew resource management is also called command, leadership, and resource management and flight deck management. Other names include maritime resource management when applied in the arena of ship handling and maintenance resource management in other arenas. A wide range of knowledge is encompassed in the crew resource management training which includes skills, knowledge and attitudes (Grogan, 2004). It also highlights the development of situational awareness, communications, teamwork, decision making and problem solving. Hence, crew resource management is defined as a system of management that optimizes the use of all the resources available. These resources include procedures, equipments and man power. This is done for the promotion of safety measures and for the enhancement of operational efficiency. This assignment is about learning and highlighting the history of aviation events and the development of crew resource management. It also focuses on the documentation of various elements that contribute to the collaboration of paramedical practice and crew resource management (Sundar, 2007). Crew resource management is a system that is involved with the interpersonal and cognitive skills which are needed for the management of resources required in a system which is organized. The cognitive attributes are meant to be the mental procedures which are utilized for maintaining and gaining awareness regarding different situations. This is done for the purpose of problem solving and for efficient decision making. In the same context, the interpersonal skills refer to the behaviours, communication skills and activities which occasionally or frequently relate to the technical attributes. Moreover, these are limited to the multi crew equipment or aircraft, when spoken in terms of aviation. They are also in relation with the single operator aircraft and equipments as they have to communicate with other crafts invariably so that the ultimate mission is accomplished (O'Connor, 2008). The recruitment and training under crew resource management has been developed and introduced by the organizations involved in aviation business. These include military aviation and major airlines. Hence, the crew resource management recruitment and training and has been made mandatory all over the world. It is mandated for commercial pilots and military pilots as well. Discussion The importance of crew resource management is mentioned in many researches and has been attributed for preventing numerous events in the past. This system is well designed and properly monitored throughout organizations. The health care system owes a great deal to the crew resource management as numerous flights require paramedical staff for coping with medical mishaps (Morey, 2003). History of crew resource management The cabin and flight crew in the present world are significantly different from the ones that existed in the commercial aviation business years back. In those days the captain of an airplane was always considered the right one and his decisions were never questioned. Other pilots on the aircraft never doubted the decision making abilities of the captain and seldom gave their input in this matter. If the decision of the captain was questioned by any of the pilots, it was regarded as a disgrace and an act of disrespect. It has been speculated that this ideology impregnated the commercial aviation from military training. It was not long ago that the military was considered the largest trainers of pilots and crew staffs. Hence, the training in military hands resulted in signs of egoistic and high-handed decision making. Regretfully, this period lacked the idea of teamwork. When the transition of working in military cockpit to commercial cockpit started, human errors increased (Kanki, 2010). These human errors resulted in taking many lives in event such as: 1. United 171 (1978): This airline ran out of fuel and it was not brought into notice in time. The event occurred in the air of Portland, Oregon. 2. Eastern 401 (1972): This airline had three crewmembers that depended on the autopilot. It went down in the Everglades when the autopilot failed. 3. Air Florida 90 (1982): This airplane was subjected to ice formation over its parts and the inexperienced crew did not follow the standard operating procedures. This resulted in a crash after it took off from Washington, D.C. After the occurrence of these events, intervention was much needed to overcome or at least minimize the human errors. Major airlines complained that there was a deficiency in the skills of the pilots. However, the pilots were technically quite competent. The ability of the pilot was to fly with the aid of Instrument Landing System approach. However, these captains were not capable of working in an environment of synergistic nature. This could lead to an antagonist, alarming and potentially dangerous situation. This lead to the Crew Resource Management development. The new insights into the prevention of aircraft accidents were the prime cause for the development of Crew Resource Management procedures. This was followed by introducing modern jet aircraft equipped with cockpit voice recorders and flight recorders. The ultimate results were quite fruitful as the data collected from these instruments suggested that approximately 70% of the aircraft accidents were due to human errors or negligence rather than technical malfunctions. Additionally, the reasons also included the fact that the crew was not able to respond effectively in critical situations. Hence, the first workshop was organized after thorough research. This workshop was organized in the year 1979 by National Aeronautics and Space Administration (NASA). The terms related to Crew resource management were never defined before the era of 1970s. Crew resource management involves the following crew and staff members who play an active role in the prevention and management of critical and undesirable situations. 1. Air Traffic Control 2. Paramedical team on ground 3. Paramedical team in aircraft 4. Cabin Crew 5. Engineering 6. Flight Crew 7. Operations 8. Ramp Workers Apart from these the Crew resource management has the following additional resources which are very much required in the whole process: 1. Our Aircraft 2. Ourselves 3. Others Advantages of Crew Resource Management Crew Resource Management is an all-inclusive system developed for the improvement of staff performance 1. It is a procedure that addresses the crew and other staff members related to the strategy of aircraft safety 2. It is a process which can be subjected to extension on all forms of training of the aircraft crew and paramedical teams members 3. It focuses on the behaviours and attitudes of the crew members and its effects on the safety. 4. It highlights the importance of teamwork by examining individual behaviours which affect the decision making 5. It places high importance on the improvement of safety and also trains for situations of accidents. 6. It is a self convincing system. However, team convincing gives exceptional outcomes in the implementation of crew resource management in paramedical practice What Crew Resource Management is not? Crew resource management has solved numerous staff related issues and prevented unlimited unfortunate events but this system is not the following: 1. Crew resource management is not an overnight fixing technique that can implemented without following standard operating procedures 2. It is not a training strategy that is developed and implemented only to fix certain cases 3. It is not a system that does not depend on other training programs 4. It is not a physical assessment or a psychological test. Hence, in paramedical practice, it is used in emergency situation more frequently. 5. It is not individual training program. Nevertheless, the individual lessons learned in this management are well-received and implemented throughout life. Health and Safety Management Model and Crew Resource Management Perezgonzalez (2005) presented a model of health and safety management is which he documented number of components and layers in a chain. Each element of the model influenced the other and also the whole process significantly. Hence, each element also reflects an effective and logical influence on the achievement of goals. The objective of this model was to influence the system of operation in order to operate in a way that maintenance of safety and health is kept intact. The main elements of this system acted as the building blocks and without these elements the system was paralysed. For the training of paramedical staff the following important points are influential in this model: 1. The setting of an objective of a goal is an essential part of plan development 2. Cooperation and communication are the key elements in ensuring the participation of each team member 3. The element of cooperation will not only enhance the final outcome but will ensure that the unfortunate events are prevented 4. Effective monitoring and acknowledging feedback is also important for the adjustment of requirements and for progression toward the goals Throughputs in Health Management and Crew Resource Management Collaboration The importance of awareness is emphasized for setting the previous goals as all the members should be properly trained and informed about the procedures, goals, outcomes and practices. An action plan is required which can produce innovative ambitions. The increment of expertise level in all individuals to get the whole outcome in a more precise manner is also required. The outputs have to the more accurate results which are maintained with throughputs and core elements. In the case of the paramedic staff, the output and throughputs are related to safety and health policies, procedures and processes (Haller, 2004). The best outcome is the safe flight. Crew fatigue management  Fatigue is a problem that plaques all the desired outcomes in paramedical training as well as crew resource management. Hence, to ensure the readiness to cope with any problem, it is vital to train the individuals in both mental and physical fitness. The ability to comply with the management of work demands is the most important in reducing crew fatigue management. All these are the requirements in theoretical settings (Leigh, 2008). On the contrary, people are subjected to being fatigued and panicked in stressful situations in which the workload can exceed individual’s ability to cope. Hence, crew resource management aims to aid the planning of in flight staff. It is essential for the administrators to keep themselves aware about the capability of a person and the performance at equal intervals. Communication and Crew Resource Management Communication plays an important role in the encouragement of multiculturalism, authority and teamwork. It enhances the main objectives of crew resource management such as self awareness, situational awareness, assertiveness, leadership skills, innovation, flexibility, assertiveness, decision making, event management, adaptability and mission analysis. Communication is also involved in the analysis of the disagreements between situations and events. The communication strategy can be implemented by teaching team members how to listen to each other, talk to each other, acknowledge feelings and be assertive. The administration has to take part in this regard (Leonard, 2004). The recording devices in the unfortunate events happening in air aid in gaining critical information. Moreover, the paramedical staff available on ground can also aid from these devices. In order to enhance the communication strategies, Todd Bishop laid out an assertive statement process based on five crucial steps. These advocacy steps include: 1. Attention getting or opening statements: It is important to address the individuals as "Captain Smith,” "Hey Chief,” or by name of the pilot. 2. Statement of Concern: The direct expression of the situation analysis without the influence of emotions. 3. Statement of the problem as seen: The uncovered statement of the problem the crew is facing or may face. 4. Statement of the Solution: In the case of a medical condition, the paramedical staff can assist the pilots or crew members in first aid while on flight. 5. Drawing an Agreement: This is where the teamwork and communication mix up. Error Management As mentioned earlier, 70% of the accidents and undesirable events happen due to human errors in aviation environment in comparison to technical problems. Defences in depth are a major concern and key concept related to the management of errors. Defence strategies can lead to the reduction, prevention and entrapment in these human and technical errors. It is a universal fact that the human errors cannot avoided. However, the important part is that the administration and the paramedical staff ensure that human errors do not result in life-threatening situations. These include accidents, crashes, and medical conditions in air. This can be achieved by two most important ways. Firstly, the reduction of errors is crucial. This can be achieved by being attentive at all times during the duty hours. When an error occurs, early observation can lead to effective remedy. Second method is to control the errors with immediate effects (Musson, 2004). Higher reliability and credibility in human performance can be achieved by observing the vulnerability of an individual in making these errors. This can be achieved by making these individuals undergo crucial training. In the case of paramedical staff, mock situations should be created in which they have to provide care at critical situations such as low oxygen levels. It is a universal fact that human reliability and vulnerability vary from situation to situation and individual to individual. Error Detection and Prevention The ideology and theory of redundancy is applicable to the entire system of aviation. Hence, it should not be assumed that a single process or a single person can prevent or reduce an error from occurring. The crew resource management is involved in the provision of redundancy which effectively highlights the role of a backup plan such as a second pilot in the cockpit along with the first pilot. This way, the second pilot can ensure the processes the first pilot has performed. This altogether rejects the ancestral ideologies of captainship. In the same manner the availability of more than one paramedical staff members is also essential on ground as well as on the flight (Kontogiannis, 2009). This is important to cater to the medical situations such as myocardial infarction, stroke, delivery, migraine, fall and injury. The presence of a second paramedic staff member will ensure dual checking and will keep the last lines of defence intact. Keeping a check throughout the process is important to minimize the errors in all situations. Hence, all the paramedical staff members and the pilots should be trained in a proficient and effective manner that may result in early error detection and prevention (Van Dyck, 2005). Briefing and Debriefing After the flight lands safely, a review should be performed which detects the performance of all the crew members. This will aid in the observation of equipments and tools. In the same manner, in the case of an undesirable event, the crew members should fill out a questionnaire to document the exact happenings. The common questions that can be added in it by the administration include: What happened? What caused the event to happen? Was the event preventable? Can this event be avoided next time? Crew Resource Management and Culture Transition In a paramedical setting the effects of crew resource management can be observed by the following cultural transitions. These are based on decision making skills, teamwork, communication and performance. S. No. Individual Culture Team Culture 1. Prime Focus on single element which is the implementation of clinical skills The focus is on dual objectives. One is the clinical skill implementation and the other is team skill development 2. There is a bleak reflection of teamwork There is a clear understanding and motivation of teamwork. 3. Performance is based on an individual The team goal is to mutually support the ultimate goal 4. Attaining, gathering and attributing information The information is shared at equal level 5. The element of self advocacy is evident Patient education and advocacy is highlighted 6. Self improvement is the main focus Improvement on the level of team is important 7. The efficiency and performance is measured on an individual level The efficiency and performance is assessed on team level 8. Individual decision making may result in faulty outcomes The whole team is well informed and collaboration is observed in the whole team. Common Red Flags in Team The red flags or warning indicate administrators that an adverse situation is about to happen. If these are observed on time and action is taken, many adverse situations can be effectively avoided. The most common red flags or warnings include: 1. Conflicting inputs 2. Confusion 3. Demoralization 4. Exploitation of ethical considerations 5. Failure to meet targets 6. Fatigue 7. Poor or absent communicating 8. Poorly addressing discrepancies 9. Preoccupation 10. Stress 11. Violation of procedures and policy (Schneiderman, 2003) Types of Medical Training Programs reflected by Crew Resource Management The following listed programs are responsible for providing training to personnel and external organizations: 1. Anaesthesia Crisis Resource Management Program 2. Classroom-based programs 3. Geriatric Interdisciplinary Team Training 4. Life wings 5. Managing Obstetric Risk Efficiently OB (MORE OB) 6. Medical Team Management 7. Med Teams 8. Multidisciplinary Obstetric Simulated Emergency Scenarios 9. Simulator-based programs 10. Team Oriented Medical Simulation (Baker, 2005). Conclusion The main focus of this assignment was to learn and document the different aspects of crew resource management. The assignment also focuses on discussing the different crucial elements of this system and its implementation health care system. Special attention has been given to the implications of this system in paramedical practice in aviation system. The elements of communication, assertion, teamwork, leadership and decision making are not only important in the prevention of human errors in the cockpit but also in the reduction of medical conditions. These medical conditions can be life-threatening. Hence, the role of a paramedical practitioner is very important in the aviation system. The in-depth understanding of crew resource management and its implementation in regular practice is important for all the health care workers. Reference Baker, D. P., Gustafson, S., Beaubien, J. M., Salas, E., & Barach, P. (2005).Medical team training programs in health care. AGENCY FOR HEALTHCARE RESEARCH AND QUALITY ROCKVILLE MD. Dunn, E. J., Mills, P. D., Neily, J., Crittenden, M. D., Carmack, A. L., & Bagian, J. P. (2007). 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