Team Resource Management

TRM training is designed to assist healthcare organisations in the prevention of adverse incidents, errors and near misses.
Throughout the healthcare system breakdowns in human interaction, communication and teamwork can have critical consequences. TRM training concerns the cognitive and interpersonal skills involved in the effective utilisation of all available resources toward safe and efficient performance of the healthcare system. The training develops safer clinical working practices through a teamwork approach to patient safety.

TRM is derived from concepts developed and proven in commercial and military aviation. Emphasis is given to the factors that affect human performance and the functioning and safety of the organisation.

The specific aims of the programme are:

• reduce the risk of harm to patients through a teamwork approach to patient safety and quality of care
• developing patient-focused, not task focused systems
• effective  coordination throughout the patient care pathway
• improving situational awareness
• improving workload management
• developing team skills and behaviours which reduce the occurrence of clinical errors

Methodologies for improving team working, removing organisational barriers and flattening hierarchies are explored through the use of the Error Chain Model. This technique has been found to promote learning from experience, develop cognitive and interpersonal skills and highlight the benefits of good teamwork in the analysis of patient safety incidents.

The training sessions cover the theoretical and practical aspects of TRM training with relevant references to, and examination of, human factor related adverse events and near misses. Sessions include the use of training video footage, incident reports, case studies, simulation exercises, group discussions and incident reviews.

Throughout the programme, an awareness of behavioural attitudes is promoted to improve and develop communication and interpersonal relationships with all those involved in the patient care pathway. The programme is designed to address the nature of the organisation's day-to-day operations as well as the associated protocols and procedures, including areas that produce particular difficulties, adverse conditions and any unusual hazards.

The outcomes of the programme will ensure that the participants have a greater awareness and understanding of how human factors and performance limitations can lead to unsafe practice. The participants will be able to identify the clues that reveal an incipient error chain and select and apply appropriate intervention strategies.

For maximum effectiveness, complete organisational involvement is required in the TRM training programme. This involvement should become an ongoing part of the programme. A key challenge for TRM programme leaders is to communicate that need to the rest of the organisation and to establish a strong commitment from top management down. A key focus of GAT TRM programmes is to establish a capability within the organisation to deliver and maintain the Team Resource Management approach to safety.