Emergency psychiatry: critical incident stress management: II. Developing a team.

Abstract

Team development Needs and resource assessment Before developing a critical incident stress management program in your emergency department, you must ascertain whether it is warranted. Determining the need for a program may involve several steps—interviewing employees, reviewing past records and incidents, reviewing the literature, and employing a consultant trained in critical incident stress management to conduct a more formal needs assessment (2). One important consideration is the size of the hospital and the volume of the emergency department. A hospital that treats fewer than 25,000 patients a year probably could not effectively maintain an independent team, given the small number of critical incidents likely to occur in such a setting. No empirically based guidelines are available, but if only one or two critical incidents occur per year, then a team devoted solely to serving the department seems unwarranted. In such cases, a critical incident stress management program might best be implemented as a collaborative effort among several emergency departments and other departments or among other departments throughout the hospital, with each providing resources and personnel.