Medical team training: applying crew resource management in the Veterans Health Administration.
Communication failures have been identified as major contributors to errors. Effective communication and teamwork are taught in aviation through crew resource management (CRM), and this article reports on application of the Medical Team Training program in 43 Veterans Administration hospitals. Individual hospitals selected among specific teamwork training programs developed by the VA's National Center for Patient Safety. These included programs tailored for operating rooms, intensive care units, and general wards, and focused on interdisciplinary communication. Implementation and evaluation of the programs are described in detail, along with examples of projects carried out at individual hospitals. While CRM programs are being implemented at the VA and elsewhere, a recent randomized trial in obstetrics units failed to show improvements in communication or patient outcomes.