Crisis Resource Management in the Delivery Room: Development of Behavioral Markers for Team Performance in Emergency Simulation

Fabrizio Bracco, Gabriele De Tonetti, Michele Masini, Marcello Passarelli, Francesca Geretto and Danilo Celleno
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Fabrizio Bracco: Department of Education Science, University of Genoa, 16128, Italy
Gabriele De Tonetti: High Intensive Care Department, Istituto di Ricovero e Cura a Carattere Scientifico Giannina Gaslini Children’s Research Hospital, 16147, Italy
Michele Masini: Department of Education Science, University of Genoa, 16128, Italy
Marcello Passarelli: National Research Council of Italy, 16149, Italy
Francesca Geretto: Department of Educational Sciences, University of Genoa, 16128, Italy
Danilo Celleno: Anesthesiology and Intensive Care Department, M.G. Vannini Hospital, Rome, 00177, Italy

IJERPH, 2018, vol. 15, issue 3, 1-10

Abstract: Human factors are the most relevant issues contributing to adverse events in obstetrics. Specific training of Crisis Resource Management (CRM) skills (i.e., problem solving and team management, resource allocation, awareness of environment, and dynamic decision-making) is now widespread and is often based on High Fidelity Simulation. In order to be used as a guideline in simulated scenarios, CRM skills need to be mapped to specific and observable behavioral markers. For this purpose, we developed a set of observable behaviors related to the main elements of CRM in the delivery room. The observational tool was then adopted in a two-days seminar on obstetric hemorrhage where teams working in obstetric wards of six Italian hospitals took part in simulations. The tool was used as a guide for the debriefing and as a peer-to-peer feedback. It was then rated for its usefulness in facilitating the reflection upon one’s own behavior, its ease of use, and its usefulness for the peer-to-peer feedback. The ratings were positive, with a median of 4 on a 5-point scale. The CRM observational tool has therefore been well-received and presents a promising level of inter-rater agreement. We believe the tool could have value in facilitating debriefing and in the peer-to-peer feedback.

Keywords: Crisis Resource Management; obstetric hemorrhage; non-technical skills; High Fidelity Simulation; delivery room (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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