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Aerospace Medicine Technical Reports

FAA Office of Aerospace Medicine
Civil Aerospace Medical Institute

Report No: DOT/FAA/AM-17/13

Title and Subtitle: Crew Resource Management in Helicopter Air Ambulance Operations: A Literature Review

Report Date: April 2017

Authors: Rowley C, Bryant MR

Abstract:
Introduction: Crew resource management (CRM) training has evolved from an aviation-specific practice to a much broader-scoped practice involving other industries with team oriented objectives. Combined objective industries such as helicopter air ambulance (HAA) operations have the unique requirement to combine ground (dispatch) and air (flight crew) with traditional medical and aviation operations in ad hoc situations adding another dimension to the CRM implementation process. Despite the requirements for such training in HAA operations, evidence suggests that CRM training does not reach all team members equally. Thus, there are gaps in the current research both in theory and practice.

Methods: Using a systematic computer query, 224 citations and 58 representative articles published from 1972 to 2015 were included in this review study. The results of the review are separated into five areas: (1) the definition of CRM and a description of implementation strategies across different industry types, (2) a description of CRM training approaches, (3) an overview of the role CRM has played in aviation and healthcare, (4) the role of dispatch and communication centers regarding CRM in HAA operations, and (5) the gaps that that exist in training and implementation strategies in CRM as they relate to HAA operations. The gaps were prioritized based on the estimated risk to HAA operations from lowest to highest.

Results: The first priority was to develop a research plan to address pilots’ risk-based decision making processes. The second and third priorities were to develop a research plan to identify gaps in medical personnel’s knowledge regarding HAA operations, including their responsibilities in flight, and to determine whether these gaps play a role in the successful implementation of CRM principles. The fourth and fifth priorities were to develop a research plan to identify gaps in supporting personnel’s (i.e., dispatch, communication centers, etc.) knowledge regarding HAA operations and to determine whether these gaps play a role in the successful implementation of CRM principles.

Discussion: Relevant CRM research from industries such as medical units, military units, and ground operations will be discussed. Cognitive and social skills associated with CRM as well as behavioral markers (e.g., communication, teamwork, and decision making) will also be shared and discussed.

Key Words: Aviation Crew Resource Management, CRM, Helicopter, Helicopter Air Ambulance, Helicopter Emergency Medical Service, HAA, HEMS, Rotorcraft

No. of Pages: 27

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