Gougoulis Anastasi, Trawber Rory, Hird Kathryn, Sweetman Greg
Medical Education Unit, Fiona Stanley Hospital, Perth, Western Australia, Australia.
School of Medicine, Notre Dame University, Fremantle, Western Australia, Australia.
J Paediatr Child Health. 2020 Jul;56(7):1134-1139. doi: 10.1111/jpc.14856. Epub 2020 Mar 20.
This study assessed the impact of a scripted, post-event debriefing tool in identifying logistical, procedural, personnel and performance obstacles and successes in a clinical setting. It was predicted that the debriefing tool would highlight the importance of routine debriefing following challenging clinical events.
The study was conducted in a 22-bed neonatal intensive care unit at a tertiary hospital and involved all staff members in the perinatal service. The debriefing tool, a two-page form providing a structured, scripted approach, was used at the earliest opportunity after acute clinical deteriorations, emergency caesarean sections and any other critical events as decided by the neonatal team. Sessions were facilitated by either a nursing or medical member of the neonatal team. Following a 2-month trial, impact was measured via the comparison of before and after survey questions as well as review of a database of issues raised, subsequent actions and outcomes.
Significant, positive changes were observed for survey questions specific to the frequency of debriefing, team communication, provision of learning opportunities and identification of logistical, equipment and procedural issues. In addition, the database highlighted the significant positive impact in day-to-day practice as a result of changes initiated by the debriefing tool. All participants requested the unit to continue using the tool.
Scripted, post-event debriefing is achievable and valuable in the clinical setting. It encourages a supportive workplace culture and empowers team members to initiate practical change in their organisations.
本研究评估了一个有脚本的事后汇报工具在识别临床环境中的后勤、程序、人员和绩效方面的障碍与成功之处的影响。预计该汇报工具将凸显具有挑战性的临床事件后进行常规汇报的重要性。
该研究在一家三级医院的一个拥有22张床位的新生儿重症监护病房进行，涉及围产期服务的所有工作人员。汇报工具是一份两页的表格，提供了一种结构化、有脚本的方法，在急性临床病情恶化、紧急剖宫产以及新生儿团队确定的任何其他关键事件后尽早使用。汇报会议由新生儿团队的一名护理人员或医疗人员主持。经过2个月的试验，通过比较调查问题的前后情况以及审查所提出问题、后续行动和结果的数据库来衡量影响。
在汇报频率、团队沟通、学习机会提供以及后勤、设备和程序问题识别等特定调查问题上观察到了显著的积极变化。此外，数据库突出了汇报工具引发的变化在日常实践中的显著积极影响。所有参与者都要求该科室继续使用该工具。
有脚本的事后汇报在临床环境中是可行且有价值的。它鼓励支持性的工作场所文化，并使团队成员有能力在其组织中发起实际变革。
