Debriefing in the Emergency Department After Clinical Events: A Practical Guide

Kessler, David; Cheng, Adam; Mullan, Paul C.

doi:10.1016/j.annemergmed.2014.10.019

Cited by 156 publications

(158 citation statements)

References 53 publications

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“…3 Integrating objective sources of feedback (e.g. CPR data from feedback device) into the discussion during debriefing has demonstrated improved outcomes after cardiac arrests 40,41 in the clinical setting and represents a method that could be used more broadly during cardiac arrest simulations and debriefings in advanced life support courses. 42 To truly capture the impact of with high fidelity manikins, we must work to define the best means of structuring debriefing sessions to facilitate meaningful learning that will impact future performance.…”

Section: Implications and Conclusionmentioning

confidence: 99%

The use of high-fidelity manikins for advanced life support training—A systematic review and meta-analysis

et al. 2015

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Section: Implications and Conclusionmentioning

confidence: 99%

The use of high-fidelity manikins for advanced life support training—A systematic review and meta-analysis

et al. 2015

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“…This may be due to implementation barriers such as lack of time, trained facilitators and a debriefing setting 10. This survey demonstrated a lack of debriefing after cardiac arrests at our hospital, with 72% of respondents reporting never having debriefed postcardiac arrest.…”

Section: Discussionmentioning

confidence: 82%

Cardiac arrest: a missed learning opportunity

Khpal

Matthewman

2016

Postgraduate Medical Journal

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Debriefing postcardiac arrest has been associated with improved return of spontaneous circulation (ROSC) neurological outcomes, hands-off compression times as well as reduced time delay to first compression. Despite the benefits, this survey has shown a lack of debriefing at our hospital. We have developed a concise debriefing tool aimed at providing much-needed training for those involved. The tool allows identification of key concerns in leadership, and teamwork and encourages open discussions around areas of concern. We believe that its implementation may improve resuscitation outcomes, and therefore, recommend its use postcardiac arrests.

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“…Practical guides for emergency department debriefing recommend standardizing the minimum number of event types to debrief in alignment with departmental goals, local needs, and priorities. 36 While we favored an inclusive list including any event for which an individual involved desired/requested a debriefing (Supplemental Digital Content, http://links. lww.com/ALN/B880), the local customization of at least a bare-minimum list can allow for standardization.…”

Section: Discussionmentioning

confidence: 99%

Failure to Debrief after Critical Events in Anesthesia Is Associated with Failures in Communication during the Event

et al. 2019

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Background: Debriefing after an actual critical event is an established good practice in medicine, but a gap exists between principle and implementation. The authors' objective was to understand barriers to debriefing, characterize quantifiable patterns and qualitative themes, and learn potential solutions through a mixed-methods study of actual critical events experienced by anesthesia personnel.Methods: At a large academic medical center, anesthesiology residents and a small number of attending anesthesiologists were audited and/or interviewed for the occurrence and patterns of debriefing after critical events during their recent shift, including operating room crises and disruptive behavior. Patterns of the events, including event locations and event types, were quantified. A comparison was done of the proportion of cases debriefed based on whether the event contained a critical communication breakdown. Qualitative analysis, using an abductive approach, was performed on the interviews to add insight to quantitative findings.Results: During a 1-yr period, 89 critical events were identified. The overall debriefing rate was 49% (44 of 89). Nearly half of events occurred outside the operating room. Events included crisis events (e.g., cardiac arrest, difficult airway requiring an urgent surgical airway), disruptive behavior, and critical communication breakdowns. Events containing critical communication breakdowns were strongly associated with not being debriefed (64.4% [29 of 45] not debriefed in events with a communication breakdown vs. 36.4% [16 of 44] not debriefed in cases without a communication breakdown; P = 0.008). Interview responses qualitatively demonstrated that lapses in communication were associated with enduring confusion that could inhibit or shape the content of discussions between involved providers.conclusions: Despite the value of proximal debriefing to reducing provider burnout and improving wellness and learning, failure to debrief after critical events can be common among anesthesia trainees and perhaps anesthesia teams. Modifiable interpersonal factors, such as communication breakdowns, were associated with the failure to debrief. (ANESTHESIOLOGY 2019; 130:1039-48) EditoR'S PERSPEctiVE What We Already Know about This Topic• Debriefing after an actual critical event is an established good practice in medicine, but a gap exists between principle and implementation. What This Article Tells us That Is New• Failure to debrief after critical events is common among anesthesia trainees and likely anesthesia teams. Communication breakdowns are associated with a high rate of the failure to debrief. . Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology's articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.anEStHESioLoGY REFLEctionS FRoM tHE Wood LiBRaRY-MuSEuM

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Debriefing in the Emergency Department After Clinical Events: A Practical Guide

Cited by 156 publications

References 53 publications

The use of high-fidelity manikins for advanced life support training—A systematic review and meta-analysis

The use of high-fidelity manikins for advanced life support training—A systematic review and meta-analysis

Cardiac arrest: a missed learning opportunity

Failure to Debrief after Critical Events in Anesthesia Is Associated with Failures in Communication during the Event

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