Greater Efficiency &

Fewer Errors, Less Rework

and Waste

Better Teamwork &

Teams

Better Care & Outcomes

Efficiency & Reliability

ResultsResults

TeamworkTeamworkTeamworkTeamwork

50

60

70

80

90

100

2007

2007

2008

2008

0

10

20

30

40

Teamwork across areas Work Efficiently as a Team

2005

2005

2006

2006

2007

2007

Source: University of Texas Medical Branch - Galveston; OR

93%93%

Safety Climate Survey ResultsSafety Climate Survey Results

69%69%Staff will freely speak up if they see

anything thatwill negatively affect

patient care

Staff will freely speak up if they see

anything thatwill negatively affect

patient care

Before CRMBefore CRM After CRMAfter CRMSource: Nebraska Medical Center; ED

94%94%

Safety Climate Survey ResultsSafety Climate Survey Results

43%43%In this unit we

discuss ways toprevent errors from

happening again

In this unit we discuss ways to

prevent errors fromhappening again

Before CRMBefore CRM After CRMAfter CRMSource: Nebraska Medical Center; ED

Improved Employee SatisfactionImproved Employee Satisfaction

• The person I report to encourages teamwork.

Statistically significant • I am a member of a group that works well together.

Statistically significant difference in response to these questions by those

who have attended CRM training

Source: Vanderbilt University Medical Center

Nurse turnover as low as 2%

Teamwork Drives Patient Satisfaction*Patient “Excellent” & “Would Recommend” Responses

Teamwork Drives Patient Satisfaction*Patient “Excellent” & “Would Recommend” Responses

5153555759616365

Ove

rall

Qu

alit

y

45474951

47 49 51 53 55 57 59

Teamwork

Ove

rall

Qu

alit

y

r = 0.973

Teamwork vs O/E Mortality*Teamwork vs O/E Mortality*

0.85

0.95

1.05

1.15

O/E

Mo

rtal

ity R = 0.586

R2 = 0.343 P < 0.0004: Y = -1.71X + 1.76

0.55

0.65

0.75

44.0% 49.0% 54.0% 59.0% 64.0%

Teamwork Excellent- (Fair+Poor)

O/E

Mo

rtal

ity

Teamwork controls 1/3 of variability in monthly O/E mortality

Reliability &

Reliability & &

Efficiency&

Efficiency

62%62%

Percentage of Uneventful CasesPercentage of Uneventful Cases

21%21%

Before CRMBefore CRM After CRMAfter CRMSource: Nebraska Medical Center; Cath Lab

62%62%

Main OR Turnover TimeMain OR Turnover Time

37%37%Percentage of turnovers

in less than 30 minutes

Percentage of turnovers

in less than 30 minutes

Before CRMBefore CRM After CRMAfter CRMSource: UTMB; OR

Reduced Case Time Minimally Invasive CABG’s*

Reduced Case Time Minimally Invasive CABG’s*

Teamwork/CRM Teamwork/CRM behaviors are the

significant factors in reducing case times

Source: Pisano, Bohmer, Edmondson Harvard Business Review 9-696-015

No correlation with type or size of

hospital, annual CV

No correlation with type or size of

hospital, annual CV hospital, annual CV case volume, or

surgeon experience.

hospital, annual CV case volume, or

surgeon experience. Source: Pisano, Bohmer, Edmondson Harvard Business Review 9-696-015

Fewer Fewer ErrorsErrors

Reduction in Wrong Surgeries

Days between Wrong Surgeries

CRM training &Tools Implementation

50% reduction in 50% reduction in open claims files open claims files for potentially for potentially compensable compensable compensable compensable eventsevents

Reduced Malpractice CostsReduced Malpractice Costs

Pediatrics

Surgery

32% Reduction in Claim $’s per Surgical Discharge

Medicine

Better Patient Better Patient Patient

OutcomesPatient

Outcomes

WHO Surgical SafetyChecklist Results*

WHO Surgical SafetyChecklist Results*

Death

Any Complication

CA

SE

S (M

EA

N)

Pre

P < 0.001

P < 0.003

P = NS

*Haynes AB. N Engl J Med 2009;360:491-9.

0 2 4 6 8 10 12

Surgical-Site Infection

Unplanned Return to OR

Pneumonia

CA

SE

S (M

EA

N)

Pre

PostP < 0.047

P < 0.001

2.50%

2.70%

2.90%

3.10%

Mortality RatesCRM Implementation

1.90%

2.10%

2.30%

2001 2002 2003 2004 2005 2006 2007Source: LifeWings Client

Source: LifeWings Client

IHI Perinatal TriggersIHI Perinatal Triggers

Better Care Better Care & Outcomes& Outcomes

Source: Salem Hospital