• Neurocritical care · Oct 2020

    Editorial

    Crisis Resource Management and High-Performing Teams in Hyperacute Stroke Care.

    • Phavalan Rajendram, Lowyl Notario, Cliff Reid, Charles R Wira, Jose I Suarez, Scott D Weingart, and Houman Khosravani.
    • Brain Resuscitation Lab, Neurology Quality and Innovation Laboratory (NQIL), Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Room H335 - 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
    • Neurocrit Care. 2020 Oct 1; 33 (2): 338-346.

    Background And PurposeManagement of stroke patients in the acute setting is a high-stakes task with several challenges including the need for rapid assessment and treatment, maintenance of high-performing team dynamics, management of cognitive load affecting providers, and factors impacting team communication. Crisis resource management (CRM) provides a framework to tackle these challenges and is well established in other resuscitative disciplines. The current Coronavirus Disease 2019 (COVID-19) pandemic has exposed a potential quality gap in emergency preparedness and the ability to adapt to emergency scenarios in real time.MethodsAvailable resources in the literature in other disciplines and expert consensus were used to identify key elements of CRM as they apply to acute stroke management.ResultsWe outline essential ingredients of CRM as a means to mitigate nontechnical challenges providers face during acute stroke care. These strategies include situational awareness, triage and prioritization, mitigation of cognitive load, team member role clarity, communication, and debriefing. Incorporation of CRM along with simulation is an established tool in other resuscitative disciplines and can be incorporated into acute stroke care.ConclusionsAs stroke care processes evolve during these trying times, the importance of consistent, safe, and efficacious care facilitated by CRM principles offers a unique avenue to alleviate human factors and support high-performing teams.

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