CHECK SIX PATIENT TRAINING SAFETY PROGRAM

What is Check Six?

Check Six is fighter pilot terminology for watching out for your teammates’ backs. Designed to transform teams into active error-avoidance systems, Check Six team training is based on Crew Resource Management (CRM), a set of proven aviation concepts and skills that reduce human error and airline crash rates. Recognized by The Joint Commission (TJC), Institute of Medicine, and AHRQ, team training is a valuable strategy for enhancing patient safety.

What are the key elements of Check Six training?

Training begins with raising awareness about the prevalence of medical errors, and the impact that inadequate teamwork and communication has on errors. Students are introduced to the field of CRM and learn about the similarities between aviation and healthcare—both fast-paced, high-risk environments, requiring close coordination among team members to accomplish a mission and avoid errors. Basic tenets of Check Six training include:

• Humans are fallible
• Healthcare is a high-risk environment
• Faulty communication and hierarchal barriers are common root causes of medical error
• Healthcare providers do not receive adequate training in communication, teamwork, and assertiveness skills
• Errors can be reduced through a definable set of teamwork concepts and skills

Leadership and Membership

Medicine’s hierarchal structure, in which leaders may be regarded as infallible and unapproachable, creates an environment of inadequate communication and increased potential for error. Check Six aims to break down this “hierarchy gradient,” so that all healthcare providers feel empowered to speak up and ask questions. Team members become more engaged in the care and safety process, while leaders benefit from the improved flow of vital information and the many sets of “extra eyes” looking out for their patients.

Situational Awareness

Situational Awareness (SA) refers to being cognizant of one’s surroundings. Loss of SA is a major factor in human error. Maintaining SA throughout the shift becomes a principal goal for safety-minded teams. Check Six students learn about the common threats to SA (e.g., rapid changes in patient volume and acuity) and are taught appropriate countermeasures.

Board Rounds

A key focus of the Check Six program is to develop a daily routine for “Board Rounds.” Board Rounds, or interdisciplinary briefings, bring together physicians and emergency department staff several times each day for team briefings. During these briefings, teams review patient and operational issues in an efficient, systematic manner. Successful implementation of Board Rounds is a major step forward for any department and a key marker of training success.

Communication and Conflict Management

Flawed communication is a common factor in causing both medical and aviation errors. Check Six teaches the importance of open, precise, and verified communication. Training provides specific skills to help manage high-risk communications, such as verbal orders and patient handoffs. Students learn and practice positive conflict management skills. They are taught to inquire when something doesn’t look right and are provided specific scripts to use for these challenging conversations. Active listening techniques are reviewed and rehearsed during the course.

How Is Check Six Training Provided?

Check Six training is delivered in a three-hour interactive course featuring a mix of didactic methods, videos, and role-playing. Ideal class size is from 20-35 students, and should include a mix of physicians and staff for each class. Up to two classes can be provided per day. Training is delivered jointly by Dr. Marc Taub, a board-certified emergency physician and a CEP America Partner, and Major Doug “Oyster” Price, Air Force fighter pilot and United Airlines officer. This training partnership provides students with a unique opportunity to learn CRM skills and how they translate from aviation to medicine. Our instructors have successfully trained hundreds of emergency providers in these principles, and look forward to imparting the principles of CRM to your teams.

For additional information about Check Six training, contact us at 800.476.1504 or checksix@cep.com.