Surrey Crisis Resource Management (SCReaM) is an innovative multidisciplinary safety initiative developed in 2014 by clinicians at the Royal Surrey NHS Foundation Trust in Guildford to improve:

• Team performance

• Staff wellbeing

• Patient safety

As healthcare workers, we are exposed to medical error on a daily basis and working under ever increasing pressure in an already overstretched NHS. Do you ever feel you fire-fight everyday to keep patients safe? It’s all too easy to keep grinding away and keep doing things the same way and expecting a different outcome, impacting patients, the NHS and just as importantly, ourselves. As highly trained individuals, we want to do the best for our patients, but currently that’s not always enough and we need to change the way we think and work.

We understand that with any training there will always be some level of degradation of knowledge over time, so in 2018 we introduced a rolling programme. This programme allows more in-depth discussion of the core CRM principles over 2 separate days with recurrent training every 1-2 years and reduces degradation.

Whether you are new to human factors or have experience in this area, this facilitative rolling training aims to help healthcare workers understand that, as humans, we make mistakes, and to promote and maintain insight, tools and techniques to help capture these in themselves, their teams and the environment in which they work. We encourage participants to anticipate and react to the longstanding but increasingly acknowledged epidemic of medical error by improving their performance, maintaining their own well-being and keeping patients safe.

In order to support the training and encourage them to put into practice their learning, participants are encouraged to produce a ‘pledge’ at the end of the course. This is to use one simple technique or tool they have learnt during the day and make a SMALL change in order to improve their individual practice or department.

Originally launched in October 2016 within operating theatres, we have since provided expanded training to other areas including Maternity, the Emergency Department and wards and are currently successfully delivering other tailored training to teams involved in specific Serious Incidents and Never Events.

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