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Did you know that more people die from medical error 

than breast and lung cancer combined?

  • Up to 25% of patients in acute care are harmed by medical error (Health Foundation 2011)

  • Medical errors are the third leading cause of death in the US alone

  • A patients length of stay is increased by 8.5 days on average as a result

  • Costing the NHS £2 billion /year

  • Frequently overlooked impact on staff when something goes wrong leading to psychological problems, stress and sickness.

  • The majority of these are due to human factors

Surrey Crisis Resource Management (SCReaM) is an innovative multidisciplinary safety initiative developed by jobbing clinicians at Royal Surrey County Foundation Hospital, Guildford in 2014 to improve: 

  • Team performance

  • Staff wellbeing 

  • Patient safety 

As a healthcare worker, 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. 

In 2015, we developed and implemented the first UK Emergency Theatre Prompt Cards to improve team performance during theatre emergencies and developed, in partnership with Orchard Team Solutions, SCReaM multidisciplinary Human Factor (HF) & Crew Resource Management (CRM) aviation style training programmes, facilitated by clinicians with an interest in human factors, and aviation pilots who are accredited CRM trainers. The courses provide participants with the opportunity to gain a solid understanding of human factors and their impact in healthcare, with additional modules including:


  • Threat and Error Management (TEM)

  • Stress and Fatigue 

  • Communication 

  • Leadership and Team Synergy

  • Situational Awareness

  • Safety Culture 

  • Decision Making


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, teams and the environment they work in, and to anticipate and react to the longstanding but increasingly acknowledged epidemic of medical error.


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


Whether you are new to human factors or have experience in this area, course participants are provided with the opportunity to develop an awareness and understanding of a wide range of tools and techniques to mitigate the effects of the daily challenges and firefighting they face in an increasingly stretched UK healthcare system to improve their performance, maintain their own wellbeing and keep patients safe.

Click here for more course details

Any initiative is only as good as the dedicated people who are passionate and enthusiastic to bring it to life. At RSCH, these trail-blazers exist in all areas of theatres and are rapidly expanding throughout the trust. If you are interested in joining us, and becoming a SCReaM champion, please contact us and tell us what you've been inspired to change through SCReaM or your ideas to push the wellbeing, performance and patient safety agenda. 


If you work at RSCH, speak to one of your local SCReaM champions to find out more about SCReaM or tell us how you think the project should evolve to support you.


Theatres HF Initial Training: Day 1
Theatres HF Initial Training: Day 2
Theatres HF Training: Recurrent
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