II. Background
- Clinical debriefing targets education and performance around critical medical events
- Contrast with emotional debriefing that focuses on emotions and stress around critical medical events
- When not addressed, unanswered questions and misunderstandings can lead to resentment and toxic environments
III. Indications
- Critical medical events (e.g. codes) with both negative outcomes as well as positive outcomes
IV. Goals
- System Safety
- Equipment, process or pathway related concerns
- Psychological Safety
- Communication around keeping the team members safe and building trust
V. Approach: INFO Mnemonic
- Immediate
- Perform debrief as soon after event as possible with minimal delay
- Often performed at the end of the event
- Consider delaying for 1-2 hours, to allow team members to process the events and develop questions
- Make time to emphasize debrief related communication
- Recognize that team learning is at the expense of the delay to return to department patient flow
- Perform debrief as soon after event as possible with minimal delay
- Non-Judgmental
- Performance feedback without blame, but rather performance improvement
- Start by thanking team members for attending the debrief and give permission to leave if needed
- Highlight goal as to learn to improve our team performance in the future
- We are not evaluating the performance of individual team members
- Fast
- Keep debriefs short (e.g. 10 to 15 minutes)
- Frame the debrief duration and goals at the begining of the debriefing session
- Opportunity
- Give team members an opportunity to ask questions and learn
- Consider starting by asking a team member to summarize the case
- Highlight measures that went well and ask team to contribute positive events they witnessed
- Ask about equipment or room concerns
- Ask about areas for improvement
- Ask what we will do differently in the next event and what will do the same with the next event
VI. Efficacy
- Improves individual and team performance by 20 to 25%
- Each individual team member may disperse their debrief learning and experience in future critical events with new teams
VII. References
- Petrosoniak, Hicks and Swaminathan (2023) The Clinical Debrief, EM:Rap, accessed 7/1/2023
- Petrosoniak (2022) CJEM 24(7): 673-4 +PMID: 36274091 [PubMed]
- Tannenbaum (2013) Hum Factors 55(1): 231-45 +PMID: 23516804 [PubMed]