From the Erasmus University Rotterdam, Erasmus School of Health Policy & Management.
University of Applied Science Rotterdam, Kenniscentrum Zorginnovatie, Rotterdam, the Netherlands.
J Patient Saf. 2021 Dec 1;17(8):e929-e958. doi: 10.1097/PTS.0000000000000816.
The aim of this article was to present an overview of the crew resource management (CRM) literature in healthcare. The first aim was to conduct an umbrella review on CRM literature reviews. The second aim was to conduct a new literature review that aims to address the gaps that were identified through the umbrella review.
First, we conducted an umbrella review to identify all reviews that have focused on CRM within the healthcare context. This step resulted in 16 literature reviews. Second, we conducted a comprehensive literature review that resulted in 106 articles.
The 16 literature reviews showed a high level of heterogeneity, which resulted in discussing 3 ambiguities: definition, outcome, and information ambiguity. As a result of these ambiguities, a new comprehensive review of the CRM literature was conducted. This review showed that CRM seems to have a positive effect on outcomes at Kirkpatrick's level 1, 2, and 3. In contrast, whether CRM has a positive effect on level 4 outcomes and how level 4 should be measured remains undetermined. Recommendations on how to implement and embed CRM training into an organization to achieve the desired effects have not been adequately considered.
The extensive nature of this review demonstrates the popularity of CRM in healthcare, but at the same time, it highlights that research tends to be situated within certain settings, focuses on particular outcomes, and has failed to address the full scope of CRM as a team intervention and a management concept.
本文旨在概述医疗保健领域的机组资源管理（CRM）文献。第一个目的是对 CRM 文献综述进行伞式综述。第二个目的是进行新的文献综述，旨在解决通过伞式综述确定的差距。
首先，我们进行了伞式综述，以确定所有关注医疗保健背景下 CRM 的综述。这一步骤产生了 16 篇文献综述。其次，我们进行了全面的文献综述，共产生了 106 篇文章。
这 16 篇文献综述显示出高度的异质性，导致讨论了 3 个模糊点：定义、结果和信息模糊。由于这些模糊性，对 CRM 文献进行了新的全面综述。这项综述表明，CRM 似乎对 Kirkpatrick 第 1、2 和 3 级的结果有积极影响。相比之下，CRM 是否对第 4 级结果有积极影响以及如何衡量第 4 级结果仍未确定。关于如何将 CRM 培训实施和嵌入组织以实现预期效果的建议尚未得到充分考虑。
本次综述的广泛性质表明 CRM 在医疗保健领域的普及程度，但同时也强调了研究往往局限于某些特定环境，关注特定结果，并且未能全面考虑 CRM 作为团队干预和管理理念的全部范围。
