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Benefits of Crisis Debriefing: Learning, Support, and Team Building
Suggested Reading 1
Melissa Nadler Scott Doheny Eric Schmalzried
Almghairbi, D. S., Marufu, T. C., & Moppett, I. K. (2018). Conflict resolution in anaesthesia: systematic review. BMJ Simulation, Technology and Enhanced Learning, 5(1), 1-7. doi: 10.1136/bmjstel-2017-000264. 2 Birnbach, D. J., Rosen, L. F., Fitzpatrick, M., Shekhter, I., & Arheart, K. L. (2021). Preparing anesthesiology residents for operating room communication challenges: A new approach for conflict resolution training. Anesthesia and Analgesia, 133(6), 1617-1623. DOI: 10.1213/ ANE.0000000000005561 3 Cullati, S., Bochatay, N., Maître, F., Laroche, T., Muller-Juge, V., Blondon, K. S., Junod Perron, N., Bajwa, N. M., Viet Vu, N., Kim, S., Savoldelli, G. L., Hudelson, P., Chopard, P., & Nendaz, M. R. (2019). When Team Conflicts Threaten Quality of Care: A Study of Health Care Professionals’ Experiences and Perceptions. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 3(1), 43-51. doi: 10.1016/j. mayocpiqo.2018.11.003. 4 Koerner, M., & Gatch, G. (1985). Communicating in the OR. Part III: Confrontation. AORN Journal, 42(2), 244-247, 250-255, 258-259. doi: 10.1016/s0001- 2092(07)63635-7. 5 Wahr, J. A., Prager, R. L., Abernathy, J. H. 3rd, Martinez, E. A., Salas, E., Seifert, P. C., Groom, R. C., Spiess, B. D., Searles, B. E., Sundt, T. M. 3rd, Sanchez, J. A., Shappell, S. A., Culig, M. H., Lazzara, E. H., Fitzgerald, D. C., Thourani, V. H., Eghtesady, P., Ikonomidis, J. S., England, M. R., Sellke, F. W., & Nussmeier, N. A. (2013). Patient safety in the cardiac operating room: human factors and teamwork: a scientific statement from the American Heart Association. AHA Circulation, 128(10), 1139-1169. doi: 10.1161/ CIR.0b013e3182a38efa.
Learning Objectives 1. Define debriefing and its role in crisis situations. 2. Discuss the benefits of proximal crisis debriefing. 3. Review the essential elements of performing a crisis debriefing.
Introduction
with its own valuable role in healthcare. Overall, debriefing is pivotal in experiential education, as it can mitigate the negative impact of crisis situations on individual providers, promoting communication and teamwork, and identify areas for improvement in patient safety. Although the potential benefits of debriefing have been recognized for decades, research indicates that debriefing after crisis events is rarely implemented. Barriers to crisis debriefing include competing urgent patient care issues, lack of trained debriefing facilitators, fear of judgment from colleagues, discomfort associated with the event itself, insufficient administrative support, and a lack of organizational buy-in. In fact, one study found that crisis events involving critical communication breakdowns were significantly less likely to be debriefed. Bridging the gap between debriefing theory and practice is essential to identify strategies that can overcome these barriers and provide benefits to individuals, teams, and the healthcare system as a whole.
The operating room is a high-risk environment where life-threatening crises can occur unexpectedly. While perioperative crises are relatively rare for individual clinicians, they are reported in millions globally each year. In such high-stress situations, effective teamwork, communication, and rapid decision making are crucial for achieving successful outcomes. However, regardless of the outcome, individuals involved must also manage the emotional implications of these crisis events, which can contribute to provider burnout. In fact, a national survey of anesthesiologists revealed that a significant percentage of respondents had experienced an unanticipated death or serious injury during their career, and a substantial number reported that they never fully recovered from the experience. Debriefing, which involves reflective conversations about performance, including feedback and analysis of performance data, plays a critical role in addressing these challenges. Performance in the operating room encompasses both taskwork (e.g., adherence to resuscitation algorithms) and teamwork (how team members collaborate to perform tasks). Debriefing can be conducted routinely or specifically after crisis events. Various types of debriefing exist, each
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