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Pract Neurol. 2019 Feb;19(1):36-42. doi: 10.1136/practneurol-2018-001966. Epub 2018 Aug 10.

Tools for your stroke team: adapting crew-resource management for acute stroke care.

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Epilepsy Center Frankfurt Rhine-Main, Goethe-University, Frankfurt am Main, Germany.
Department of Neurology, Goethe-University, Frankfurt am Main, Germany.


Crew-resource management is an approach to work and training that focuses on non-technical skills and strategies to prevent human error in complex procedures. It was initially termed 'cockpit-resource management' and developed for aviation in the 1970s after several severe accidents; it has contributed to a measurable increase in flight safety. In recent years, this approach has been successfully implemented in other high-reliability environments; surgical disciplines have made particular use of crew-resource management strategies and training, with resulting reduced mortality rates. The stepwise implementation of different crew-resource management strategies in stroke care at our tertiary stroke centre has helped to speed up process times significantly, and to improve patient safety and staff satisfaction. Here, we summarise our experience in adapting different crew-resource management tools to acute stroke care, sharing specific tools that have proven valuable in our hands, and we encourage colleagues to implement such strategies in acute stroke care.


communication; crew resource management; stroke; stroke team; team time-out

[Indexed for MEDLINE]

Conflict of interest statement

Competing interests: LMW, NK and PR report no conflicts of interest. FB reports travel grants from Stryker and speakers honoraria from Medtronic outside the submitted work. WP received research support, travel grants, consultancy and speakers honoraria from Boehringer Ingelheim, Stryker, Medtronic, Novartis, Sanofi-Aventis, Bayer Healthcare outside the submitted work.

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