Turkish Journal of Anaesthesiology & Reanimation

Implementation of Crisis-Resource-Management-based Team Training in Lower Austria


Department of Anaesthesiology, Emergency and Critical Care Medicine and Karl Landsteiner Institute of Medical Simulation, Patient Safety and Emergency Medicine, General Hospital Wiener Neustadt, Austria


Medical University Vienna, Austria


Department of Pediatrics, General Hospital Wiener Neustadt, Wiener Neustadt, Austria


Department of Anesthesiology and Intensive Care, Landesklinikum Neunkirchen, Austria

Turk J Anaesthesiol Reanim 2021; 49: 152-158
DOI: 10.5152/TJAR.2020.359
Read: 374 Downloads: 83 Published: 21 April 2021

Objective: Sequelae of medical errors are a significant problem in acute care. Human-factor-based events are frequent but avoidable causes. Thus, non-technical skills are crucial. In 2008, crisis-resource-management (CRM)-based simulation training was established for the medical staff of the Lower Austria Regional Hospitals, one of the largest hospital operators in Europe. 

Methods: Implementation and development of simulation training from 2008 until today are described, costs and performance data retrospectively analysed over a 10-year period. The applied methodology and organisational aspects of CRM training are highlighted. To complete the picture, activities triggered through CRM training throughout the hospitals with potential to further improve patient safety are shown. 

Results: With an initial funding of €100,000 by the Landeskliniken Holding and course rates of €350 to €500, a simulation programme was established for approximately 1,900 co-workers in the acute care setting. In the past 10 years, more than 2,300 doctors and nurses took part in one of the courses, held by 14 qualified trainers. Training was held in the simulation centre as well as in hospitals. Over the time, simulation facilities have been expanded to 8 different manikins, high-fidelity ventilation and monitoring simulation. In addition, a variety of patient safety activities like implementation of critical incident reporting, OR checklists and anaesthesia briefing was accompanied by the trainer team. The total cost of the project was just under €20, 00,000.

Conclusion: Simulation-based CRM training was successfully introduced and sustainably institutionalised at the NOE LKH group of hospitals. The demand for and acceptance of the training were both excellent. The previous costs of training were relatively low; the organisational model of an independent, non-profit registered association allowed the training activities to be implemented without reducing the availability of the instructors in their clinical roles.

Cite this article as: Trimmel H, Csomor D, Seedoch M, Drach E, Trimmel A. Implementation of Crisis-Resource-Management-based Team Training in Lower Austria. Turk J Anaesthesiol Reanim 2021; 49(2): 152-8.

EISSN 2667-6370