Rail Resource Management and developed a free kit of resources. Operating train crews at the National Railroad Passenger Corporation (Amtrak) in the United States are instructed on CRM principles during yearly training courses. CRM has been adopted by merchant shipping worldwide. The STCW Convention and STCW Code, 2017 edition, published by the I.M.O. states the requirements for Bridge Resource Management and Engine Room Resource Management training. These are approved shore-based training, simulator training, or approved in-service experience. Most maritime colleges hold courses for deck and engine room officers. Refresher courses are held every five years. These are referred to as Maritime resource management. Firefighting Following its successful use in aviation training, CRM was identified as a potential safety improvement program for the fire services. Ted Putnam wrote a paper that applied CRM concepts to the violent deaths of 14 Wildland firefighters on the South Canyon Fire in Colorado. From this paper, a movement was initiated in the Wildland and Structural Fire Services to apply CRM concepts to emergency response situations. Various programs have since been developed to train emergency responders in these concepts and to help track breakdowns in these stressful environments. The International Association of Fire Chiefs published its first CRM manual for the fire service in 2001. It is currently in its third edition. Several industry-specific textbooks have also been published. Healthcare Elements of CRM have been applied in US healthcare since the late 1990s, specifically in infection prevention. For example, the "central line bundle" of best practices recommends using a checklist when inserting a central venous catheter. The observer checking off the checklist is usually lower-ranking than the person inserting the catheter. The observer is encouraged to communicate when elements of the bundle are not executed; for example if a breach in sterility has occurred. TeamSTEPPS The Agency for Healthcare Research and Quality (AHRQ), a division of the United States Department of Health and Human Services, also provides training based on CRM principles to healthcare teams. This training, called Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS), and the program is currently being implemented in hospitals, long-term care facilities, and primary care clinics around the world. TeamSTEPPs was designed to improve patient safety by teaching healthcare providers how to better collaborate with each other by using tools such as huddles, debriefs, handoffs, and check-backs. Implementing TeamSTEPPS has been shown to improve patient safety. There