Clinical Event Debrief

Aka: Clinical Event Debrief

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II. Background

  1. Clinical debriefing targets education and performance around critical medical events
    1. Contrast with emotional debriefing that focuses on emotions and stress around critical medical events
    2. When not addressed, unanswered questions and misunderstandings can lead to resentment and toxic environments

III. Indications

  1. Critical medical events (e.g. codes) with both negative outcomes as well as positive outcomes

IV. Goals

  1. System Safety
    1. Equipment, process or pathway related concerns
  2. Psychological Safety
    1. Communication around keeping the team members safe and building trust

V. Approach: INFO Mnemonic

  1. Immediate
    1. Perform debrief as soon after event as possible with minimal delay
      1. Often performed at the end of the event
      2. Consider delaying for 1-2 hours, to allow team members to process the events and develop questions
    2. Make time to emphasize debrief related communication
      1. Recognize that team learning is at the expense of the delay to return to department patient flow
  2. Non-Judgmental
    1. Performance feedback without blame, but rather performance improvement
    2. Start by thanking team members for attending the debrief and give permission to leave if needed
    3. Highlight goal as to learn to improve our team performance in the future
      1. We are not evaluating the performance of individual team members
  3. Fast
    1. Keep debriefs short (e.g. 10 to 15 minutes)
    2. Frame the debrief duration and goals at the begining of the debriefing session
  4. Opportunity
    1. Give team members an opportunity to ask questions and learn
    2. Consider starting by asking a team member to summarize the case
    3. Highlight measures that went well and ask team to contribute positive events they witnessed
    4. Ask about equipment or room concerns
    5. Ask about areas for improvement
    6. Ask what we will do differently in the next event and what will do the same with the next event

VI. Efficacy

  1. Improves individual and team performance by 20 to 25%
  2. Each individual team member may disperse their debrief learning and experience in future critical events with new teams

VII. References

  1. Petrosoniak, Hicks and Swaminathan (2023) The Clinical Debrief, EM:Rap, accessed 7/1/2023
  2. Petrosoniak (2022) CJEM 24(7): 673-4 +PMID: 36274091 [PubMed]
  3. Tannenbaum (2013) Hum Factors 55(1): 231-45 +PMID: 23516804 [PubMed]

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