Debriefing and QI Compressed

DEBRIEFING AND

CARDIAC ARRESTQUALITY

IMPROVEMENT

OBJECTIVES

PROBLEMS AT A GLANCE PART 1

PROBLEMS AT A GLANCE PART 2

SURVIVAL TO DISCHARGE

“IS ALL OVER THE MAP”

DEVELOPING A CULTURE OF EXCELLENCE

BASTARD LIFESAVER

S

I HATEWAITIN

G!DAMN EMTS

WE CAN DO EVEN BETTER!

A NECESSARY COMBINATION!

DEBRIEFING IS CHEAP!

Debriefing of cardiac arrest events, either in isolation or as part of an

organized response system, improves subsequent

CPR performance in-hospital and results in higher rate of return of spontaneous circulation (ROSC). Debriefing of actual resuscitation events can be a useful strategy to

improvefuture performance (Class IIa, LOE

C).

Innovative concepts to reduce the decay of skills and knowledge may include continuous maintenance of competency programs that employ

frequent short-duration interactions with content and skills after an initial course, or they may include guided

debriefings after real-life events that focus on response

improvement.

Debriefing is a learner-focused, nonthreatening technique to assist

individual rescuers or teams to reflect on, and improve,

performance. In manikin-based studies, debriefing as part of the

learning strategy resulted in improved performance in

post-debriefing simulated scenarios, and it improved adherence to

resuscitation guidelines in clinical settings.

Debriefing as a technique to facilitate learning should be included in all

advanced life support courses (ClassI, LOE B).

Our Definition!

A provider‐centric process designed to standardize the debriefing process to assist

clinicians in thinking about what they did, how they did it, and how

they can improve.

Structured and Supported Debriefing

A provider-centered approach

emphasizes self-discovery and self-critique.

A provider-centeredapproach also draws upon professional experience

andmotivation to perform well to enhance performance

and outcomes.

Thoughtful discussion after an attempted resuscitation is important to facilitate the sorting out of events

as well as gaining insight on what happened and why

We often learn better through self‐discovery

and self‐analysis than by other methods!

PROVIDERS NEED TO EXPRESS

THEMSELVES AND THEIR FEELINGS…

AND THIS IS A GREAT FORUM FOR

THAT!

•Have long term view•Patients and patience•INSTANT GRATIFICATION!

IMPLEMENTATION

Supported elements include both interpersonal support as well as use of protocols, algorithms, and

best evidence to inform debriefing statements/questions.

Structured and Supported Debriefing

Structured elements include three specific debriefing phases with related goals, actions, and

time estimates.

Structured and Supported Debriefing

Team leader trained in Structured

and Supported Debriefings

ROLE OF FACILITATOR

•PROVIDE SAFE ENVIRONMENT FOR SHARING EXPERIENCES

•DRAW OUT INFORMATION AND EXPERIENCES

•CONTENT DIRECTED BY THE CREW

•NEVER JUDGE!

Gather, Analyze, Summarize

USE UNTAPPEDDATA!

NOT PUNATIVE!

PIZZA DIPLOMACY!

BOY, I AM REALLY

LOOKING FORWARD TO

THE DEBRIEFING

ON THIS CASE!