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Every resus needs a debrief

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Sonia Twigg gave this talk at our 2022 DFTB conference in Brisbane.

Unlocking the Power of Clinical Debriefing

Let’s dive into a crucial aspect of healthcare — clinical debriefing. Dr. Sonia Twigg, a pediatric Emergency Physician, shares insights into the significance of debriefing, particularly focusing on “hot debriefs.”

The Need for Debriefs

Recognizing their Importance

In the realm of healthcare, the significance of clinical debriefing cannot be overstated. It emerges as a vital learning conversation, particularly in the aftermath of critical events, fostering a collective understanding within the entire medical team. Termed “hot debriefs,” these discussions occur promptly after an event or, at the latest, by the end of a shift, aligning seamlessly with the workflow of emergency department physicians.

While the enthusiasm for debriefing is unanimous among clinicians, the implementation falls short of the ideal frequency. Despite its acknowledged value, barriers such as workload constraints, lack of institutional guidelines, and insufficient training impede the regularity of these crucial conversations. Addressing these barriers becomes paramount as clinical debriefing transcends mere individual learning; it evolves into a catalyst for team enhancement and system-wide improvement.

Recognizing its potential impact, healthcare organizations are increasingly advocating for the integration of clinical debriefing into their practices. Teams engaging in post-event discussions witness a substantial 25% performance improvement, exemplifying the transformative power of this practice. The challenge lies in not merely acknowledging its importance but in cultivating a culture that embraces and prioritizes these debriefs as integral to the continuous enhancement of patient care.

Lived Experiences and Learning

Benefits of Debriefing

Clinical debriefing offers a multifaceted approach to professional and personal development within healthcare settings.

Firstly, it serves as an invaluable educational tool, providing individuals with the opportunity to learn and grow through constructive feedback. This aspect is crucial for ongoing improvement, ensuring healthcare professionals can adapt and enhance their skills based on real-world experiences.

Additionally, debriefing plays a pivotal role in emotional processing, offering a structured environment for individuals to navigate and process the complex emotions that may arise after challenging cases. By acknowledging and addressing these emotions, healthcare professionals can foster resilience and maintain their well-being.

Moreover, the team support aspect of debriefing is integral to building a culture of solidarity and mutual learning. Through open discussions, team members can share their unique perspectives and insights, creating a collaborative environment where collective experiences contribute to the growth and cohesion of the entire healthcare team. In essence, the benefits of debriefing extend beyond individual skill enhancement, encompassing emotional well-being and fostering a sense of camaraderie and shared learning among healthcare professionals.

Well-being and Psychological Safety

Addressing Concerns

In the realm of addressing concerns within the debriefing process, Dr. Twigg places a paramount emphasis on psychological safety. Recognizing the delicate nature of discussing challenging cases and personal experiences, we need an environment where individuals feel secure and supported. This psychological safety, crucial for open communication, evolves over time and is rooted in consistent actions rather than verbal assurances.

Integral to the establishment of this psychological safety is the gradual building of trust. This trust is not an instantaneous achievement but a product of sustained effort and reliability. It is cultivated through a series of interactions where team members can rely on the confidentiality and support provided during debriefs. This gradual evolution of trust underscores the significance of a long-term commitment to creating a safe space for open dialogue.

Moreover, in addressing concerns, it is important to set clear expectations for the debriefing sessions. By communicating a shared purpose centred around learning and improvement rather than blame, we can ensure that the debriefing environment is conducive to constructive discussions. This proactive approach establishes a framework that encourages participants to focus on personal and collective growth, fostering a culture of continuous improvement within the healthcare team.

Practical Steps for Debriefing

There are many valuable tools to enhance the process. One such tool is the “Critical Incident Debriefing Toolkit” authored by Liz Crowe. This resource serves as a comprehensive guide, offering detailed steps to structure and optimize debriefing sessions.

The debriefing process encompasses a number of specific stages. These include pre-briefing, wherein objectives are set, facilitator roles are assigned, and the groundwork for the session is established. The reactions phase follows, providing a platform for participants to express their thoughts and emotions. Subsequently, a structured summary of the discussion ensues, facilitating a cohesive understanding of key takeaways. To further enhance the reflective process, Dr. Twigg introduces a plus-delta analysis, emphasizing both positive aspects and areas for improvement.

In addition to these structured approaches, you can incorporate online tools to augment the debriefing experience. Platforms such as the “Talk Foundation” offer supplementary resources, contributing to the richness and effectiveness of the overall debriefing strategy.

Author

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