Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19
Abstract Background Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety duri...
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| Format: | Article |
| Language: | English |
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BMC
2020-11-01
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| Series: | Advances in Simulation |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s41077-020-00150-0 |
| _version_ | 1818456161888763904 |
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| author | Jean-Christophe Servotte T. Bram Welch-Horan Paul Mullan Justine Piazza Alexandre Ghuysen Demian Szyld |
| author_facet | Jean-Christophe Servotte T. Bram Welch-Horan Paul Mullan Justine Piazza Alexandre Ghuysen Demian Szyld |
| author_sort | Jean-Christophe Servotte |
| collection | DOAJ |
| description | Abstract Background Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety during the COVID-19 pandemic. Methods We reviewed existing literature on best-practice guidelines to answer key clinical debriefing program design questions. An end-of-shift huddle format for the debriefs allowed multiple cases of suspected or confirmed COVID-19 illness to be discussed in the same session, promoting situational awareness and team learning. A novel ED-based clinical debriefing tool was implemented and titled Debriefing In Situ COVID-19 to Encourage Reflection and Plus-Delta in Healthcare After Shifts End (DISCOVER-PHASE). A facilitator experienced in simulation debriefings would facilitate a short (10–25 min) discussion of the relevant cases by following a scripted series of stages for debriefing. Data on the number of debriefing opportunities, frequency of utilization of debriefing, debriefing location, and professional background of the facilitator were analyzed. Results During the study period, the ED treated 3386 suspected or confirmed COVID-19 cases, with 11 deaths and 77 ICU admissions. Of the 187 debriefing opportunities in the first 8-week period, 163 (87.2%) were performed. Of the 24 debriefings not performed, 21 (87.5%) of these were during the four first weeks (21/24; 87.5%). Clinical debriefings had a median duration of 10 min (IQR 7–13). They were mostly facilitated by a nurse (85.9%) and mainly performed remotely (89.8%). Conclusion Debriefing with DISCOVER-PHASE during the COVID-19 pandemic were performed often, were relatively brief, and were most often led remotely by a nurse facilitator. Future research should describe the clinical and organizational impact of this DISCOVER-PHASE. |
| first_indexed | 2024-12-14T22:22:17Z |
| format | Article |
| id | doaj.art-7c1fc2267e424470a302ae0c4640fc3d |
| institution | Directory Open Access Journal |
| issn | 2059-0628 |
| language | English |
| last_indexed | 2024-12-14T22:22:17Z |
| publishDate | 2020-11-01 |
| publisher | BMC |
| record_format | Article |
| series | Advances in Simulation |
| spelling | doaj.art-7c1fc2267e424470a302ae0c4640fc3d2022-12-21T22:45:28ZengBMCAdvances in Simulation2059-06282020-11-015111110.1186/s41077-020-00150-0Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19Jean-Christophe Servotte0T. Bram Welch-Horan1Paul Mullan2Justine Piazza3Alexandre Ghuysen4Demian Szyld5Public Health Sciences Department, University of LiegeDirector of Simulation, Section of Pediatric Emergency Medicine, Baylor College of Medicine, Texas Children’s HospitalDirector of Research and Quality Improvement, Division of Emergency Medicine, Children’s Hospital of the King’s Daughters, Eastern Virginia Medical SchoolInterdisciplinary Medical Simulation Center of Liege, University of LiegePublic Health Sciences Department, University of LiegeSenior Director, Institute for Medical Simulation, Center for Medical Simulation, Brigham and Women’s Hospital, Harvard Medical SchoolAbstract Background Multiple guidelines recommend debriefing after clinical events in the emergency department (ED) to improve performance, but their implementation has been limited. We aimed to start a clinical debriefing program to identify opportunities to address teamwork and patient safety during the COVID-19 pandemic. Methods We reviewed existing literature on best-practice guidelines to answer key clinical debriefing program design questions. An end-of-shift huddle format for the debriefs allowed multiple cases of suspected or confirmed COVID-19 illness to be discussed in the same session, promoting situational awareness and team learning. A novel ED-based clinical debriefing tool was implemented and titled Debriefing In Situ COVID-19 to Encourage Reflection and Plus-Delta in Healthcare After Shifts End (DISCOVER-PHASE). A facilitator experienced in simulation debriefings would facilitate a short (10–25 min) discussion of the relevant cases by following a scripted series of stages for debriefing. Data on the number of debriefing opportunities, frequency of utilization of debriefing, debriefing location, and professional background of the facilitator were analyzed. Results During the study period, the ED treated 3386 suspected or confirmed COVID-19 cases, with 11 deaths and 77 ICU admissions. Of the 187 debriefing opportunities in the first 8-week period, 163 (87.2%) were performed. Of the 24 debriefings not performed, 21 (87.5%) of these were during the four first weeks (21/24; 87.5%). Clinical debriefings had a median duration of 10 min (IQR 7–13). They were mostly facilitated by a nurse (85.9%) and mainly performed remotely (89.8%). Conclusion Debriefing with DISCOVER-PHASE during the COVID-19 pandemic were performed often, were relatively brief, and were most often led remotely by a nurse facilitator. Future research should describe the clinical and organizational impact of this DISCOVER-PHASE.http://link.springer.com/article/10.1186/s41077-020-00150-0Clinical event debriefingImplementationCOVID-19CommunicationSafetyQuality |
| spellingShingle | Jean-Christophe Servotte T. Bram Welch-Horan Paul Mullan Justine Piazza Alexandre Ghuysen Demian Szyld Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 Advances in Simulation Clinical event debriefing Implementation COVID-19 Communication Safety Quality |
| title | Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 |
| title_full | Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 |
| title_fullStr | Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 |
| title_full_unstemmed | Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 |
| title_short | Development and implementation of an end-of-shift clinical debriefing method for emergency departments during COVID-19 |
| title_sort | development and implementation of an end of shift clinical debriefing method for emergency departments during covid 19 |
| topic | Clinical event debriefing Implementation COVID-19 Communication Safety Quality |
| url | http://link.springer.com/article/10.1186/s41077-020-00150-0 |
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