Debrief it all: a tool for inclusion of Safety-II

Bentley, Suzanne; McNamara, Shannon; Meguerdichian, Michael; Walker, Katie; Patterson, Mary; Bajaj, Komal

doi:10.1186/s41077-021-00163-3

Cited by 21 publications

(16 citation statements)

References 22 publications

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“…43 Bentley et al provide a rationale and an outline for utilizing Safety II principles in debriefing. 40 The overall focus encourages learners to understand and acknowledge normal workflow (i.e., work as done) and recognize how/why adaptation did or did not occur. Balancing Safety I and Safety II principles in debriefing can help learners improve performance and identify team-/system-level issues that threaten safety.…”

Section: Training Concepts That Facilitate the Development Of Adaptiv...mentioning

confidence: 99%

“…Bentley et al provide a rationale and an outline for utilizing Safety II principles in debriefing 40 . The overall focus encourages learners to understand and acknowledge normal workflow (i.e., work as done) and recognize how/why adaptation did or did not occur.…”

Section: Conceptual Models and Guiding Principlesmentioning

confidence: 99%

“…Framing training as an opportunity to make and learn from errors encourages trainees to develop problem‐solving or hypothesis‐testing skills and strategies for managing affective responses (e.g., frustration and anxiety). Incorporate lessons on how to alter coordination strategies in training 39 When task demands are low, trainees should learn to discuss possible problems that could arise later in the task. By discussing their coordination strategies during this period, they will likely reduce the amount of communication necessary to achieve successful team performance later and allow them to be adaptive when novel problems arise in the environment. Include Safety II principles during debriefing to support the development of adaptive capacity 40 Existing safety improvement efforts focus largely on prevention of error by identifying what went wrong and “fixing” it. This approach, termed Safety I, assumes an idealized view of work where there are simple, rational processes and error results directly from failure(s) within the system 41 .…”

Section: Conceptual Models and Guiding Principlesmentioning

confidence: 99%

“…Discuss team member understanding and mental model development during debriefing to help reinforce the importance of discussing and practicing team coordination. 39 • Include Safety II principles during debriefing to support the development of adaptive capacity 40 Existing safety improvement efforts focus largely on prevention of error by identifying what went wrong and "fixing" it. This approach, termed Safety I, assumes an idealized view of work where there are simple, rational processes and error results directly from failure(s) within the system.…”

Section: Training Concepts That Facilitate the Development Of Adaptiv...mentioning

confidence: 99%

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Developing adaptive performance: A conceptual model to guide simulation‐based training design

Fernandez

Rosenman

Plaza‐Verduin

et al. 2022

AEM Education and Training

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Objectives Effective emergency department care requires individuals and teams to adapt to changes in patient condition, team factors, environmental issues, and system‐level challenges. Adaptability is often listed as an important skill for emergency medicine physicians; however, conceptual models describing the processes involved in adaptive performance have not been translated for health care settings. Similarly, educators have not described training design strategies that support the development of adaptive performance. Methods We examined the team science and health care literatures for key concepts in adaptive performance, health care team performance, and diagnostic decision‐making. Using expert consensus, we integrated these concepts to develop the team adaptive performance model and to identify training design approaches that support the development of adaptability. Results We identify nine training principles supported by the team adaptive performance model and the adaptive learning system. Each training principle is accompanied by recommendations and mechanisms for implementation in emergency medicine simulation–based education. Conclusion Training experiences can be designed to target processes that support adaptive performance.

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Section: Training Concepts That Facilitate the Development Of Adaptiv...mentioning

confidence: 99%

Section: Conceptual Models and Guiding Principlesmentioning

confidence: 99%

Section: Conceptual Models and Guiding Principlesmentioning

confidence: 99%

Section: Training Concepts That Facilitate the Development Of Adaptiv...mentioning

confidence: 99%

See 2 more Smart Citations

Developing adaptive performance: A conceptual model to guide simulation‐based training design

Fernandez

Rosenman

Plaza‐Verduin

et al. 2022

AEM Education and Training

View full text Add to dashboard Cite

show abstract

“…Clinical debriefings are a relatively new area of practice. Studies have investigated the most effective method for conducting debriefings in the clinical environment (8,9,(15)(16)(17)(18). However, evidence regarding the frequency of post-shift debriefings and their embedding in a global strategy is scarce.…”

Section: Introductionmentioning

confidence: 99%

“Debriefing and Organizational Lessons Learned” (DOLL): A Qualitative Study to Develop a Classification Framework for Reporting Clinical Debriefing Results

et al. 2022

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BackgroundThe COVID-19 crisis has radically affected our healthcare institutions. Debriefings in clinical settings provide a time for the clinicians to reflect on the successes (pluses) and difficulties (deltas) encountered. Debriefings tend to be well-received if included in the broader management of the unit. The goal of this study was to develop a framework to categorize these debriefings and to assess its worthiness.MethodsA qualitative approach based on a grounded theory research method was adopted resulting in the “Debriefing and Organizational Lessons Learned” (DOLL) framework. Debriefings were conducted within two Emergency Departments of a Belgian University Hospital during an 8-week period. In the first step, three researchers used debriefing transcripts to inductively develop a tentative framework. During the second step, these three researchers conducted independent categorizations of the debriefings using the developed framework. In step 3, the team analyzed the data to understand the utility of the framework. Chi-square was conducted to examine the associations between the item types (pluses and deltas) and the framework's dimensions.ResultsThe DOLL is composed of seven dimensions and 13 subdimensions. Applied to 163 debriefings, the model identified 339 items, including 97 pluses and 242 deltas. Results revealed that there was an association between the frequency of pluses and deltas and the dimensions (p < 0.001). The deltas were mainly related to the work environment (equipment and maintenance) (p < 0.001) while the pluses identified tended to be related to the organization of the unit (communication and roles) (p < 0.001). With leadership's support and subsequent actions, clinicians were more enthusiastic about participating and the researchers anecdotally detected a switch toward a more positive organizational learning approach.ConclusionThe framework increases the potential value of clinical debriefings because it organizes results into actionable areas. Indeed, leadership found the DOLL to be a useful management tool. Further research is needed to investigate how DOLL may work in non-crisis circumstances and further apply the DOLL into incident reporting and risk management process of the unit.

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Patient Safety: History, Current Models, and Future Directions for Improvement

Braaten

2024

The Nexus Between Nursing and Patient Safety

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Debrief it all: a tool for inclusion of Safety-II

Cited by 21 publications

References 22 publications

Developing adaptive performance: A conceptual model to guide simulation‐based training design

Developing adaptive performance: A conceptual model to guide simulation‐based training design

“Debriefing and Organizational Lessons Learned” (DOLL): A Qualitative Study to Develop a Classification Framework for Reporting Clinical Debriefing Results

Patient Safety: History, Current Models, and Future Directions for Improvement

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