Teamwork and communication among healthcare professionals leads to better patient outcomes in 3 key ways: 1) It reduces medical errors and unnecessary rework or waste, improving efficiency and reliability. 2) It enhances safety, with staff more willing to speak up about issues and more discussion of how to prevent future errors. 3) It achieves better patient satisfaction, quality of care, and health outcomes as measured by lower mortality rates and complication rates.

1. Better
Teamwork &
Teams
Fewer Errors,
Less Rework
and Waste
Greater
Efficiency &
Reliability
Better Care &
Outcomes
Results

2. Teamwork

3. 100
90
2008
80
2008
70
60
2007
50 2007
2006
40
2005
2006
2005
30
20
10
0
Teamwork across areas Work Efficiently as a
Team
Source: University of Texas Medical Branch - Galveston; OR

4. Safety Climate Survey Results
93%
Staff will freely 69%
speak up if they see
anything that
will negatively affect
patient care
Before CRM After CRM
Source: Nebraska Medical Center; ED

5. Safety Climate Survey Results
94%
In this unit we
discuss ways to 43%
prevent errors from
happening again
Before CRM After CRM
Source: Nebraska Medical Center; ED

6. Improved Employee Satisfaction
• The person I report
to encourages
teamwork.
Statistically significant • I am a member of a
difference in response to group that works
well together.
these questions by those
who have attended
CRM training
Source: Vanderbilt University Medical Center

7. Nurse turnover as low as 2%

8. Teamwork Drives Patient Satisfaction*
Patient “Excellent” & “Would Recommend” Responses
65
63
61
Overall Quality
59
57
55
53
51
49
47
45
47 49 51 53 55 57 59
Teamwork
r = 0.973

9. Teamwork vs O/E Mortality*
1.15
1.05
R = 0.586
O/E Mortality
0.95 R2 = 0.343
P < 0.0004:
0.85 Y = -1.71X + 1.76
0.75
0.65
0.55
44.0% 49.0% 54.0% 59.0% 64.0%
Teamwork Excellent- (Fair+Poor)
Teamwork controls 1/3 of variability in monthly O/E mortality

10. Reliability
&
Efficiency

11. Percentage of Uneventful Cases
62%
21%
Before CRM After CRM
Source: Nebraska Medical Center; Cath Lab

12. Main OR Turnover Time
62%
Percentage of 37%
turnovers
in less than
30 minutes
Before CRM After CRM
Source: UTMB; OR

13. Reduced Case Time
Minimally Invasive CABG’s*
Teamwork/CRM
behaviors are the
significant factors in
reducing case times
Source: Pisano, Bohmer, Edmondson Harvard Business Review 9-696-015

14. No correlation with
type or size of
hospital, annual CV
case volume, or
surgeon experience.
Source: Pisano, Bohmer, Edmondson Harvard Business Review 9-696-015

15. Fewer
Errors

16. Reduction in Wrong Surgeries
Days between Wrong Surgeries
CRM training &
Tools Implementation

17. 50% reduction in
open claims files
for potentially
compensable
events

18. Reduced Malpractice Costs
Pediatrics
Surgery
Medicine
32% Reduction in Claim $’s per Surgical Discharge

19. Better
Patient
Outcomes

20. WHO Surgical Safety
Checklist Results*
P < 0.001
Any Complication
P < 0.003
CASES (MEAN)
Death
P = NS
Pre
Pneumonia Post
P < 0.047
Unplanned Return to OR
P < 0.001
Surgical-Site Infection
0 2 4 6 8 10 12
*Haynes AB. N Engl J Med 2009;360:491-9.

21. 3.10%
2.90% Mortality Rates
2.70% CRM Implementation
2.50%
2.30%
2.10%
1.90%
2001 2002 2003 2004 2005 2006 2007
Source: LifeWings Client

22. Source: LifeWings Client

23. Better Care
& Outcomes
IHI Perinatal Triggers
Source: Salem Hospital