Implementing an ED Critical Incident Stress Management Team

Wuthnow, Julia; Elwell, Sean; Quillen, Joann McDaniels; Ciancaglione, Nicole

doi:10.1016/j.jen.2016.04.008

Cited by 7 publications

(6 citation statements)

References 4 publications

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“…This may lessen the burden of factors we know lead to burnout such as grief, anger, stress and anxiety, and the second victim syndrome often experienced by providers. 4…”

Section: Impact On Provider Perceptionmentioning

confidence: 99%

“…1 Events involving pediatric patients are particularly impactful. [2][3][4] The American Heart Association and the American Academy of Pediatrics recommend consideration of debriefings after such events 5,6 because they promote communication, improve team performance, 7 improve patient survival outcomes, 8,9 and decrease provider stress. 2 Debriefings take many forms and may be any communication after an event intending to discuss team dynamics, actions, or improve learning and performance.…”

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confidence: 99%

“…Critical events are common in the emergency department (ED) given the undifferentiated and often critical patient population 1 . Events involving pediatric patients are particularly impactful 2–4 . The American Heart Association and the American Academy of Pediatrics recommend consideration of debriefings after such events 5,6 because they promote communication, improve team performance, 7 improve patient survival outcomes, 8,9 and decrease provider stress 2 .…”

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confidence: 99%

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Development, Implementation, and Provider Perception of Standardized Critical Event Debriefing in a Pediatric Emergency Department

Grither,

Leonard,

Whiteley

et al. 2023

Pediatr Emer Care

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Objective Hot debriefings are communications among team members occurring shortly after an event. They have been shown to improve team performance and communication. Best practice guidelines encourage hot debriefings, but these are often not routinely performed. We aim to describe the development and implementation of a multidisciplinary hot debriefing process in our pediatric emergency department (ED), and its impact on hot debriefing completion and provider perceptions. Methods An internal tool and protocol for hot debriefings were developed by integrating responses from a survey of those who work in the ED at our institution and previously published debriefing tools. Charge nurses and pediatric emergency medicine physicians were trained to lead hot debriefings. Surveys on the perception of hot debriefings were administered before and 6 months postimplementation. Twelve-month baseline data were established by asking physicians who cared for patients who died in the ED or within 48 hours of admission to recall debrief completion. Debriefs were then prospectively tracked for 6 months postimplementation. Results Debrief completion for patient deaths in the ED or within 48 hours of admission increased from 23% (5/22) to 75% (12/16) (P < 0.001). When assessing just those deaths within the ED, this number increased from 31% (5/16) to 85% (11/13) (P < 0.001). There were 98 responses to a baseline survey (response rate, 60.5%). Most who were surveyed felt that debriefs rarely occurred, preferred hot debriefings to cold debriefings, and felt that more hot debriefings should occur. Perceived barriers included lack of time, interest, protocol, trained facilitators, departmental support, and inability to gather the team. There were 88 responses to a postintervention survey (response rate, 56.8%), 50 of which had participated in a debrief and were included in analysis. Those surveyed felt that debriefs occurred more often and were more often valuable. Most perceived that barriers were significantly reduced. Most respondents felt that hot debriefs helped address systems issues and improved performance. Conclusions Implementation of a protocol for physician or charge nurse-led hot debriefings in our pediatric ED resulted in increased completion, perceived barrier reduction, and a uniform approach to address identified issues. Pediatric EDs should consider adoption of a hot debriefing protocol given these benefits.

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“…This may lessen the burden of factors we know lead to burnout such as grief, anger, stress and anxiety, and the second victim syndrome often experienced by providers. 4…”

Section: Impact On Provider Perceptionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Development, Implementation, and Provider Perception of Standardized Critical Event Debriefing in a Pediatric Emergency Department

Grither,

Leonard,

Whiteley

et al. 2023

Pediatr Emer Care

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“…Given CISM's role as a primary method of managing critical incident stress among emergency responders, it was selected as the intervention around which to build the HOPES team. 13,14…”

Section: Addressing Critical Incident Stressmentioning

confidence: 99%

“…Although the types of critical incidents may not directly overlap between first responders and PHO personnel, the impact and emotional responses to these incidents are quite similar. Given CISM's role as a primary method of managing critical incident stress among emergency responders, it was selected as the intervention around which to build the HOPES team 13,14 …”

Section: Introductionmentioning

confidence: 99%

How I approach peer support in pediatric hematology/oncology

Nadel

Barbach

Fish

2020

Pediatric Blood & Cancer

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Peer support has begun to gain traction as a mechanism for improving well‐being in medicine. In this paper, we share our experience building, training, and piloting a peer support team based on a “critical incident stress management” model. The HOPES team (Helping Our Peers Endure Stress) is dedicated to, and composed entirely of, members of our division of pediatric hematology/oncology. Peer support will not solve all the well‐being problems afflicting medicine. It is, however, a very good place to start.

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Administration in Emergency Psychiatry

Simpson

Curry

2020

Models of Emergency Psychiatric Services That Work

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Implementing an ED Critical Incident Stress Management Team

Cited by 7 publications

References 4 publications

Development, Implementation, and Provider Perception of Standardized Critical Event Debriefing in a Pediatric Emergency Department

Development, Implementation, and Provider Perception of Standardized Critical Event Debriefing in a Pediatric Emergency Department

How I approach peer support in pediatric hematology/oncology

Administration in Emergency Psychiatry

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