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Tools for your stroke team: adapting crew-resource management for acute stroke care
  1. Laurent M. Willems1,2,
  2. Natalia Kurka2,
  3. Ferdinand Bohmann2,
  4. Peter Rostek2,
  5. Waltraud Pfeilschifter2
  1. 1 Epilepsy Center Frankfurt Rhine-Main, Goethe-University, Frankfurt am Main, Germany
  2. 2 Department of Neurology, Goethe-University, Frankfurt am Main, Germany
  1. Correspondence to Dr. Laurent M. Willems, Epilepsy Centre Frankfurt Rhine-Main and Department of Neurology, Goethe-University Frankfurt, Frankfurt am Main 60528, Germany; Laurent.Willems{at}


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
  • stroke
  • crew resource management
  • team time-out
  • stroke team

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  • Contributors LMW designed the stroke-specific '10-for-10'. LMW and WP conceived the manuscript. LMW, NK, WP, FB and PR wrote the paper.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Disclaimer The authors confirm that they have read the Journal’s position on issues involved in ethical publication and affirm that this report is consistent with those guidelines.

  • 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.

  • Patient consent Not required.

  • Provenance and peer review Commissioned. Externally peer reviewed by David Nicholl, Birmingham, UK, and Martin Punter, Manchester, UK

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