The initial treatment of the trauma patient is a demanding challenge, and well recognised to be the phase with most protocol deviation and treatment mishaps. The resuscitation must be made in correct order to ensure that no valuable time is lost. In Norway very few hospitals get enough trauma cases to enable the trauma teams to perform optimal just by doing the regular work.
Training is one of the ways to make up for this gap between expected and actual experience. Aviation safety work has shown that human factors and sub-optimal team co-operation can lead to disasters, and the crew resource management (CRM) training has been developed to address this. This is even more true in medicine. Modern medicine is complicated, and the human factors tend to be forgotten in technology. For the patients it is the sum of the trauma team’s performance that matters. We developed a multi-professional course with simulated trauma patients, organised locally at each hospital called BEST (Better & Systematic Trauma Care) in 1997. This training method spread by word-of-mouth to Norwegian hospitals, initially as trauma team training. During ten years all Norwegian hospitals caring for trauma had arranged own local training, and interested colleagues from other medical fields adapted the training to e.g. resuscitation of new-borns, stroke, severely ill medical patients etc. Gradually BEST developed into Better & Systematic Team training, still BEST.
