"This is the fascinating story of the development and implementation of Crew Resource Management (CRM) in aviation and how it can and must be employed in health care. In spite of differences between aviation and health care, the similarities are more striking. Both are intrinsically hazardous endeavors, with complex technology, and dominated by one profession. Both developed a dysfunctional hierarchical culture that substantially increases risk for its customers and patients. Aviation has done something about it: CRM, with dramatic results. Flying is now incredibly safe. The lessons are clear, the cause is urgent, and the time has come for all health care organizations to act accordingly."
"This book is a revelation! Anyone who believes that toxic hierarchies and dangerously ineffective communication are inevitable in health care should think again. Beyond the Checklist heralds a new kind of hospital workplace—one that’s already been flight-tested. The dysfunctions of our health care system are tragic and unnecessary, but they can be fixed. This book shows us how."
"The deeper I progressed into this terrific book, the more embarrassed I became for my profession of medicine. Behind our casual assumption as airline customers that we will arrive safely lies an enormously complex process that addresses all human and system issues that could possibly affect safety in air travel. With a few notable exceptions, we in medicine do not come anywhere remotely close to where we need to be to assure our patients of this same kind of safety commitment. There can be no excuse for medicine not pursuing this same all-engaging, relentless process. Our patients deserve nothing less. This is a must-read book for anyone with any connection at all to the delivery of health care services."
“Beyond the Checklist helps us understand that successfully providing safe and reliable care for our patients requires a multifaceted approach. Mechanisms such as checklists need to be integrated with effective leadership, teamwork, knowledge about human factors, and continuous learning. This book provides valuable insights on a journey that will provide a better care experience for patients, their families, and the people providing care.”
“Beyond the Checklist recognizes that it takes more than just the standardized execution of processes to create a culture of safety. As the authors reveal, the team intelligence needed in more hospitals can flourish only in a workplace environment where there is proper training, mutual respect, and real cooperation among coworkers.”
“Beyond the Checklist takes us behind an apparently simple tool to lay out the complex social and organizational transformation that makes the checklist effective in aviation and to argue for a similar top-to-bottom transformation of health care. By shifting our attention to the detailed, sustained, and careful work that will be required to make health care safer, the book moves us forward on a long, difficult, but ultimately rewarding journey.”
“Beyond the Checklist provides a timely and insightful assessment of crew resource management (CRM), a key tool for averting disaster in the airline industry. The authors make a compelling case for its application to health care delivery. This book should become an essential text for health care professionals, educators, and policymakers seeking to improve interprofessional training and practice.”
“The ideas presented in this book are so clearly developed and the writing so engaging that its audience will not be limited to patient safety experts. Patients, their families, and health care providers of all kinds will also benefit from the authors’ insight into hospital safety improvement. The case studies are rich in detail and full of critical reflections on the connection between quality care and optimally functioning teams. The tone of Beyond the Checklist is hopeful but, for good reason, very urgent as well.”
“Some experts downplay the parallels between health care and aviation, but there is much we can learn from the system-wide change that greatly improved passenger safety on commercial airlines. This excellent book highlights the innovative programs of pioneering hospitals where better teamwork and effective communication guide every interaction-from the bedside to the boardroom.”
“This important book brings both a sense of urgency and the hope of clarity in addressing a fundamental and widespread problem in health care. It is a must-read for clinicians and students who deliver care and a call for leadership from every member of the interprofessional team. Leadership is required to change the culture and systems of care delivery. Beyond the Checklist provides the inspiration and a path for that change.”
“Beyond the Checklist shows us that Crew Resource Management principles help us deal with our human inability to always perform ‘perfectly’ while operating in a complex work environment. Little mistakes in aviation compound into huge problems. In commercial airlines, virtual strangers routinely solve complex problems without making critical mistakes. The culture of CRM provides for this as a normal way of operation. If embraced by the field of medicine, it will totally transform the way the industry operates.”
“As a primary care physician in a busy academic clinic, I found this book both fascinating and thought provoking. Since reading it I have spent considerable time talking with non-physician colleagues about how they spend their days, how they view their doctor colleagues, and how we might improve teamwork. The increasingly computerized medical world has exacerbated the reality of all people working individually in silos, striving to do good work, but inadvertently creating redundancies and lapses. It’s also a lonelier and more stressful work routine. Like the airline industry, medicine is a people undertaking and direct, consistent, respectful communication not only forms a more supportive, safe and enjoyable work environment but also lessens the chance of errors. The great challenge is to identify tasks in medicine that would be better done in identical ways. I suspect more streamlining will improve care, support, and safety and also free up time and space for the human part of our work, which is in such jeopardy these days as well.”