Crew Resource Management: The Flight Plan for Lasting ... (ISBN 157839712X)

Important Premise, Questionable Value:
As a pilot and longtime Crew Resource Management (CRM) instructor, I was glad to get this book. The authors are well qualified to teach CRM, and the book makes many interesting points for hospitals considering implementing CRM. The history and premises of CRM are discussed, followed by keys to program development, methods of implementation, and the importance of timely expert feedback. The book concludes with a sobering example of the need for CRM in a hospital environment. I have been involved in developing and teaching a variety of CRM courses in my professional career, and have been academically interested in CRM (and similar programs) in High Reliability Organizations (HRO) such as chemical processing and commercial nuclear power generation for many years. Although my professional background is in aviation, I find many parallels with medicine in this book. Given that all the authors have more than a passing relationship with aviation, I was surprised to see some of the errors in the discussion of the aviation roots of CRM. I am extremely familiar with the accidents they discuss, but while none of the factual errors changes the desired interpretations of the accidents in question, the facts are just as easy to report correctly. The discussion of the June 26, 1988 A-320 accident at Mulhouse-Habsheim airport in Alsace (France) is a particular annoyance; while the authors do attempt to convey the gist of the accident correctly, the assertion that "the pilots pushed the wrong buttons in the cockpit" (resulting in a crash) is factually incorrect, and in context leads to some erroneous conclusions for ill-informed readers. Although this is the example I found personally most annoying, it is not the only error in the book: either the authors tried to dumb the curriculum down (which I presume not to be the case given the intended audience for this book) or they are not as firmly grounded in the specifics of the accidents they cite as I would like them to be. The good news, though, is that the book gives a good introduction to the importance of standardization, good checklist design, and removing barriers to effective communication, three fundamentals of good CRM. I had hoped for a somewhat more extensive coverage of CRM risk assessment and mitigation in hospitals, but this is actually more of a "how to" book, which is interesting in its own right. The content of the book is generally good, but it is scant (127 pages) and has a very cheap binding; the fact that it costs 99 dollars makes it a poor value proposition. For that reason I gave it a rating of three stars overall. Unless your interest is strictly setting up a CRM program for large hospitals, a much better book (and value) is "Culture at Work in Aviation and Medicine: National, Organizational and Professional Influences" by Robert L. Helmreich and Ashleigh C. Merritt. Helmreich is commonly regarded as "the father of CRM" and his work is always first-rate and academically rigorous, though a bit more difficult to read.

From Cockpit to Cath Lab - Medical Error Reduction:
Mix NASA Flight Surgeons, Top Gun Pilot instructors, a culture of medicine prone to error and a movement to change this to a safer culture. The result is this map for change that explains in understandable terms just what is wrong, what needs to change, and how to change it. Though geared as an introduction into the LifeWings Program, this book will provide strong fundamentals for anyone interested in or planning CRM-based medical training for their medical system.