Clinical event debriefing: a review of approaches and objectives.

Abstract

This review explores four different approaches and clarifies objectives for debriefing after a clinical event in the emergency department. Psychological debriefing aims to prevent or reduce symptoms of traumatic stress and normalize recovery. Psychological first aid helps team members provide each other with pragmatic social support. Debriefing for simulation-based education promotes learning by team members. Quality improvement approaches and after action reviews focus on systems improvement. Qualitative studies have begun to explore interactions between clinical staff after a significant clinical event. Clearer descriptions and measurements of quality improvements and the effect of clinical event debriefing on patient outcomes are appearing. An increasing number of studies describe melded, scripted approaches to the hot debrief. Clinical staff have consistently indicated they value debriefing after a significant clinical event. Differing objectives from different approaches have translated into a wide variety of methods and a lack of clarity about relevant outcomes to measure. Recent descriptions of scripted approaches may clarify these objectives and pave the way for measuring relevant outcomes that demonstrate the effectiveness of and find the place for debriefing in the emergency department.