Critical Event Debriefing in a Community Hospital

• Published in: Curēus (Palo Alto, CA) CA), 2020-06, Vol.12 (6), p.e8822-e8822
• Main Authors: Ugwu, Chidiebere V, Medows, Marsha, Don-Pedro, Data, Chan, Joseph
• Format: Article
• Language: English
• Subjects: Emergency medical care; Emergency Medicine; Health care; Hospitals; Intensive care; Medical Education; Medical errors; Medical personnel; Medical Simulation; Patient safety; Pediatrics; Reflective teaching; Social workers
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.8822

IntroductionMedical error is currently the third major cause of death in the United States after cardiac disease and cancer. A significant number of root cause analyses performed revealed that medical errors are mostly attributed to human errors and communication gaps. Debriefing has been identified as a major tool used in identifying medical errors, improving communication, reviewing team performance, and providing emotional support following a critical event. Despite being aware of the importance of debriefing, most healthcare providers fail to make use of this tool on a regular basis, and very few studies have been conducted in regard to the practice of debriefing. This study ascertains the frequency, current practice, and limitations of debriefing following critical events in a community hospital.Design/MethodsThis was a cross-sectional observational study conducted among attending physicians, physician assistants, residents, and nurses who work in high acuity areas located in the study location. Data on current debriefing practices were obtained and analyzed using descriptive statistics.ResultsA total of 130 respondents participated in this study. Following a critical event in their department, 65 (50%) respondents reported little (75% of the time). Debriefing was done more than once a week as reported by 35 (26.9%) of the respondents and was led by attending physicians 77 (59.2%). The debrief session sometimes occurred immediately following a critical event (46.9%). Although 118 (90%) of the respondents feel that there is a need to receive some training on debriefing, only 51 (39%) of the respondents have received some form of formal training on the practice of debriefing. Among the healthcare providers who had some form of debriefing in their practice, the few debrief sessions held were to discuss medical management, identify problems with systems/processes, and provide emotional support. Increased workload was identified by 92 (70.8%) respondents as the major limitations to the practice of debriefing. Most respondents support that debriefing should be done immediately after a critical event such as death of a patient (123 [94.6%]), trauma resuscitation (108 [83.1%]), cardiopulmonary arrest (122 [93.8%]), and multiple casualty/disasters (95 [73.1%]).ConclusionsIn order to reduce medical errors, hospitals and its management team must create an