Name/Claim/Aim Around the World

Blog - Name/Claim/Aim Around the World

During a critical event, clinical teams need to rapidly organize and apply crisis resource management (CRM) principles. However, miscommunication and lack of a clear leader can delay interventions, leading to negative patient outcomes.

Name/Claim/Aim© is a crisis resource management mnemonic used to help teams quickly organize and apply crisis resource management (CRM) principles during an adverse event. The mnemonic was created at the Center for Medical Simulation (CMS) by Robert Nadelberg, MD; Rebecca Minehart, M.D; MSHPEd; Jenny Rudolph, PhD; and Roxane Gardner, MD, MSHPEd, D.Sc. using the CRM principles outlined by David Gaba, MD and colleagues.

Participants of CMS’ clinical simulation courses are taught how to utilize Name-Claim-Aim during simulated crisis scenarios, and the tool is starting to gain traction oversees.

“It’s a simple and efficient mnemonic to organize a team in the middle of a crisis,” says, Dr. José M. Maestre about Name/Claim/Aim. At the Hospital virtual Valdecilla (HvV) in Spain, Dr. Maestre has been working to share the benefits of N/C/A with learners in critical care and anesthesiology. Dr. Maestre first learned about Name-Claim-Aim through working with CMS faculty; his home institution, HvV, is a CMS Affiliate organization. Dr. Maestre began working with Name/Claim/Aim with his team and created a Spanish translation for the tool: Nombra/ Establece/ Orienta. Dr. Maestra and Dr. Ignacio Del Moral shared the concept during hospital grand rounds in 2018.

Not long after learning about Name-Claim-Aim, the Spanish Society of Critical Care reached out to Dr. Maestre, Dr. Del Moral, and the HvV team to assist with training their instructors for upcoming CRM courses in Spain. The society needed the group to train instructors for crisis resource management courses the society was organizing throughout Spain. During their discussions, Name/Claim/Aim was brought up and the society expressed interest in Dr. Maestre and his team including the mnemonic in their instruction.

Dr. Maestre and the HvV team worked with around 25 CRM instructors from all over Spain. The participants first completed a webinar on basic concepts of CRM and Name/Claim/Aim, and then came to HvV for a 12-hr course to practice their skills. Each participant had the opportunity to engage in simulation as a learner and then as an instructor, giving them the tools needed to teach the Name-Claim-Aim concept to their peers when returning to their home institution.

Using the same webinar/simulation course model, Dr. Maestre and his team trained almost 100 anesthesiologists (all with teaching appointments in Spain) on the principles of CRM and Name/Claim/Aim. Whether training anesthesiologists or CRM instructors, Dr. Maestre noted that the participants quickly adopted Name-Claim-Aim: “People found the algorithm to be really practical because these two specialties deal with critical situations…they liked the idea of a simple way to organize themselves.”

At CMS’ Advanced Instructor Course, a session on deliberate practice introduces the concept of Name/Claim/Aim. Dr. Francine Morin, an internist at CHU Sainte-Justine Sim Nation Center at the University of Montreal, attended the course and was captivated by the concept.  “It is a practical algorithm; Name/Claim/Aim is like “ABC” (airway, breathing, circulation) for teamwork,” says Dr. Morin.

After finishing the course and returning to Canada, Dr. Morin sent a message to Jenny Rudolph asking if her team could observe a clinical course and see Name/Claim/Aim in action. Less than a year after completing the Advanced Instructor Course, Dr. Morin was heading back to Boston to watch a labor and delivery simulation at CMS. Thrilled by the experience and what she saw, Dr. Morin began translating Name-Claim-Aim in French. The result is DÉCLARE /ORGANISE /DIRIGE or DecODe (the last “e” standing for environment).

Jenny Rudolph and Dr. Morin’s team presented a workshop on N/C/A at SIM Expo 2019 in Montreal. Next, Dr. Morin will present at the Royal College Sim Summit in November. In January 2020, Dr. Morin and her team will start running in-situ simulation that will involve nurses, orderlies, and staff. She wants to incorporate DecODe in these sessions.

Back at CMS, Roxane Gardner is working with Fernando Salvetti and Barbara Bertani to use e-REAL, an enhanced reality system, to teach elements of Name/Claim/Aim to labor and delivery course participants. Salvetti and Bertani, founders of Logosnet, installed the e-REAL system at CMS in Boston, transforming two walls into an interactive teaching tool. Gardner, Salvetti, Bertani, and Rebecca Minehart have published their findings on Name/Claim/Aim and e-REAL in the paper, Teamwork and Crisis Resource Management for Labor and Delivery Clinicians: Interactive Visualization to Enhance Teamwork, Situational Awareness, Contextual Intelligence and Cognitive Retention in Medical Simulation.

Name/Claim/Aim continues to garner attention at institutions around the world. Through CRM courses, presentations, and publications, individuals are learning about the benefits of Name/Claim/Aim and adopting it as a teaching and organizational tool.