Patient Safety Improvement with Crew Resource Management : transformation from a blame culture to a learning culture

Abstract: Background Being able to learn from mistakes is a vital aspect of nurse’s professionalism and increasing patient safety. With Crew Resource Management methodologies, aviation and other High Risk Organisations have succeeded in enabling learning cultures that should be applicable also to healthcare. Purpose The purpose was to describe how Crew Resource Management and the inherent learning culture could improve nurse’s professionalism and patient safety within the healthcare system.  Method A literature overview based on database searches in CINAHL, PubMed and a manual search, resulting in 25 scientific articles analysed using an integrated analysis method and quality review.  Results Crew Resource Management implementations have a positive effect on the nurse’s professional role and patient safety but have still not reached the full potential. Incident reporting is a key factor in providing feedback but still encounters barriers as a basis for pre-emptive learning. Identified barriers are not using Crew Resource Management components as a whole, a lack of feedback and an insufficient learning culture. Feedback is connected to nurse’s perception and situational awareness strengthening morale and professionalism. Conclusion Nurses professionalism and patient safety is dependent on being able to learn from mistakes which is a key aspect of Crew Resource Management. Learning is enabled by the reporting of mistakes in incident reporting systems without the fear of being punished. Improvements to both systems and the reporting culture are seen as needed, as-well as changes to the education system promoting reporting as part of an overall safety and learning culture.