Crew resource management

CRM is the "effective use of all available resources by individuals and crews to safely and effectively accomplish a mission or task, as well as identifying and managing the conditions that lead to error." CRM training encompasses a wide range of knowledge, skills, and attitudes including communications, situational awareness, problem solving, decision making, and teamwork. Although there is no universal CRM program, airlines usually customize their training to best suit the needs of the organization. The principles of each program are usually closely aligned. According to the U.S. Navy, there are seven critical CRM skills: The application of CRM has been developed in a series of generations: • First generation: emphasized individual psychology and testing, where corrections could be made to behavior. • Second generation: featured a shift in focus to cockpit group dynamics. • Third evolution: diversification of scope and an emphasis on training crews in how they must function both in and out of the cockpit. • Fourth generation: CRM integrated procedure into training, allowing organizations to tailor training to their needs. • Fifth generation (current): acknowledges that human error is inevitable and provides information to improve safety standards. Today, CRM is implemented through pilot and crew training sessions, simulations, and through interactions with senior ranked personnel and flight instructors such as briefing and debriefing flights. Although it is difficult to measure the success of CRM programs, studies have been conclusive that there is a correlation between CRM programs and better risk management. The U.S. Air Force and U.S. Navy require all air crew members to receive annual CRM training to reduce human-error-caused mishaps. The U.S. Army has its own version of CRM called Aircrew Coordination Training Enhanced (ACT-E). == Case studies ==

United Airlines Flight 173 When the crew of United Airlines Flight 173 was making an approach to Portland International Airport on the evening of Dec 28, 1978, they experienced a landing gear abnormality. The captain decided to enter a holding pattern so they could troubleshoot the problem. The captain focused on the landing gear problem for an hour, ignoring repeated hints from the first officer and the flight engineer about their dwindling fuel supply, and only realized the situation when the engines began flaming out. The aircraft crash-landed in a suburb of Portland, Oregon, over short of the runway. Of the 189 people aboard, two crew members and eight passengers died. The NTSB Safety Recommendation A-79-47 called on the FAA to: Issue an operations bulletin to all air carrier operations inspectors directing them to urge their assigned operators to ensure that their flight crews are indoctrinated in principles of flight deck resource management, with particular emphasis on the merits of participative management for Captains and assertiveness training for other cockpit crewmembers. (Class II, Priority Action) (A-79-47) Diehl and the runway collision between Pan Am and KLM Boeing 747s at Tenerife. United Airlines Flight 232 Captain Al Haynes, pilot of United Airlines Flight 232, credits CRM as being one of the factors that saved his own life, and many others, in the Sioux City, Iowa crash of July 1989: Air France 447 One analysis blames failure to follow proper CRM procedures as being a contributing factor that led to the 2009 fatal crash into the Atlantic Ocean of Air France Flight 447 from Rio de Janeiro to Paris. The final report concluded the aircraft crashed after temporary inconsistencies between the airspeed measurements—likely due to the aircraft's pitot tubes being obstructed by ice crystals—caused the autopilot to disconnect, after which the crew reacted incorrectly, causing the aircraft to enter an aerodynamic stall from which it did not recover. Following recovery of the black box two years later, independent analyses were published before and after the official report was issued by the BEA, France's air safety board. One was a French report in the book "Erreurs de Pilotage" written by Jean-Pierre Otelli, which leaked the final minutes of recorded cockpit conversation. According to Popular Mechanics, which examined the cockpit conversation just before the crash: The men are utterly failing to engage in an important process known as crew resource management, or CRM. They are failing, essentially, to cooperate. It is not clear to either one of them who is responsible for what, and who is doing what. Qantas Flight 32 The success of the Qantas Flight 32 flight has been attributed to teamwork and CRM skills. Susan Parson, the editor of the Federal Aviation Administration (FAA) Safety Briefing wrote; "Clearly, the QF32 crew's performance was a bravura example of the professionalism and airmanship every aviation citizen should aspire to emulate". Carey Edwards, author of Airmanship, wrote: Their crew performance, communications, leadership, teamwork, workload management, situation awareness, problem solving and decision making resulted in no injuries to the 450 passengers and crew. QF32 will remain as one of the finest examples of airmanship in the history of aviation. ==Adoption in other fields==

Transportation The basic concepts and ideology of CRM have proven successful in other related fields. In the 1990s, several commercial aviation firms and international aviation safety agencies began expanding CRM into air traffic control, aircraft design, and aircraft maintenance. The aircraft maintenance section of this training expansion gained traction as maintenance resource management (MRM). To attempt to standardize industry-wide MRM training, the FAA issued Advisory Circular 120–72, "Maintenance Resource Management Training" in September 2000. Following a study of aviation mishaps between 1992 and 2002, the United States Air Force determined that close to 18% of its aircraft mishaps were directly attributable to human error in maintenance, which often occurred long before the flight in which the problems were discovered. These "latent errors" include failures to follow published aircraft manuals, lack of assertive communication among maintenance technicians, poor supervision, and improper assembly practices. In 2005, to address these human-error-induced aircraft mishaps, Lt Col Doug Slocum, Chief of Safety at the Air National Guard's (ANG) 162nd Fighter Wing, Tucson, directed the modification of the base's CRM program into a military version called maintenance resource management (MRM). In mid-2005, the Air National Guard's Aviation Safety Division converted Slocum's MRM program into a national program available to the Air National Guard's flying wings in 54 U.S. states and territories. In 2006, the Defense Safety Oversight Council (DSOC) of the U.S. Department of Defense (DoD) recognized the mishap-prevention value of this maintenance safety program by partially funding a variant of ANG MRM for training throughout the U.S. Air Force. This ANG initiated, DoD-funded version of MRM became known as Air Force Maintenance Resource Management (AF-MRM) and is now widely used in the U.S. Air Force. The Rail Safety Regulators Panel of Australia has adapted CRM to rail as rail resource management and developed a free resource kit. Operating train crews at the National Railroad Passenger Corporation (Amtrak) in the United States are instructed on CRM principles during yearly training courses. CRM has been adopted by merchant shipping worldwide. The STCW Convention and STCW Code, 2017 edition, published by the I.M.O. states the requirements for bridge resource management and engine room resource management training. These are approved shore-based training, simulator training, or approved in-service experience. Most maritime colleges hold courses for deck and engine room officers. Refresher courses are held every five years. These are referred to as maritime resource management. Firefighting Following its successful use in aviation training, CRM was identified as a potential safety improvement program for the fire services. Ted Putnam advocated for improved attention to human factors that contribute to accidents and near misses, building on CRM principles. In 1995, Dr. Putnam organized the first Human Factors Workshop for wildland fire. The manual was a joint effort between the U.S. Fire Administration, the Foundation for Firefighter Health and Safety and Volunteer Fireman’s Insurance Services, with some initial funding contributed by Dennis Smith. In 2024, the fourth edition of the manual was released. Healthcare Elements of CRM have been applied in US healthcare since the late 1990s, specifically in infection prevention. For example, the "central line bundle" of best practices recommends using a checklist when inserting a central venous catheter. The observer checking off the checklist is usually lower-ranking than the person inserting the catheter. The observer is encouraged to communicate when elements of the bundle are not executed; for example if a breach in sterility has occurred. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) The Agency for Healthcare Research and Quality (AHRQ), a division of the United States Department of Health and Human Services, also provides training based on CRM principles to healthcare teams. This training, called Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), and the program is currently being implemented in hospitals, long-term care facilities, and primary care clinics around the world. TeamSTEPPs was designed to improve patient safety by teaching healthcare providers how to better collaborate with each other by using tools such as huddles, debriefs, handoffs, and check-backs. There is evidence TeamSTEPPS interventions are difficult to implement and are not universally effective. ==See also==