Department of Emergency Medicine, Brigham and Women's Hospital , Boston, MA, USA.
Harvard Medical School , Boston, MA, USA.
J Interprof Care. 2020 Sep-Oct;34(5):711-715. doi: 10.1080/13561820.2020.1813697. Epub 2020 Sep 29.
The COVID-19 pandemic has instigated significant changes for health care systems. With clinician burnout rising, efforts to promote clinician resilience are essential. Within this quality improvement project, an interprofessional debriefing program (Brigham Resilience in COVID-19-pandemic Emergency Forum-BRIEF) was developed within two emergency departments (EDs). An interprofessional group of ED providers led optional, nightly debriefings using a web-based portal to connect with ED clinicians for six weeks. In total, 81 interprofessional staff participated in nightly debriefings with a 47% attendance rate. On average, three participants attended the BRIEF nightly (range = 2-8) to discuss the challenges of social distancing, scarce resources, high acuity, clinician burnout and mental health. Participation increased as rates of COVID-19 positive patients rose. Debriefing leaders provided ED leadership with summaries of clinician experiences and suggestions for improvements. Feedback supported quality improvement initiatives within the ED and greater mental health support for staff. Clinicians and administrators provided positive feedback regarding the program's impact on clinician morale, and clinical processes that promoted the safety and quality of patient care. Optional debriefing with receptive departmental leadership may be a successful tool to support clinicians and hospitals during critical events.
COVID-19 大流行促使医疗保健系统发生了重大变化。随着临床医生倦怠的加剧,促进临床医生韧性的努力至关重要。在这个质量改进项目中,在两个急诊科内开发了一个跨专业的汇报方案(Brigham Resilience in COVID-19-pandemic Emergency Forum-BRIEF)。一组由急诊科医生组成的跨专业小组使用基于网络的门户,每周六晚进行可选的汇报,为期六周。共有 81 名跨专业人员参加了每晚的汇报,出勤率为 47%。平均每晚有三人参加 BRIEF(范围为 2-8),讨论社交距离、资源短缺、高发病率、临床医生倦怠和心理健康方面的挑战。随着 COVID-19 阳性患者的增加,参与度也有所增加。汇报领导向急诊科领导提供了关于临床医生经验的总结和改进建议。反馈支持了急诊科的质量改进计划,并为员工提供了更大的心理健康支持。临床医生和管理人员对该计划对临床医生士气和促进患者护理安全和质量的临床流程的影响给予了积极反馈。在关键事件期间,与乐于接受的部门领导进行可选的汇报可能是支持临床医生和医院的有效工具。