Journal Article

The impact of a fellow-driven debriefing program after pediatric cardiac arrests

Gillen, Jennifer, Hough, Rebecca F., Palumbo, Kathryn, Aponte-Patel, Linda, Yalamanchi, Sirisha, Sen, Anita I., Koncicki, Monica L., Daube, Ariel, Chirico, Amy, Choudhury, Tarif, Patel, Anita, Lin, Cheryl

2019

Overview

Background In the United States, post-cardiac arrest debriefing has increased, but historically it has occurred rarely in our pediatric intensive care unit (PICU). A fellow-led debriefing tool was developed as a tool for fellow development, as well as to enhance communication amongst a multidisciplinary team. Methods A curriculum and debriefing tool for fellow facilitators was developed and introduced in a 41-bed cardiac and medical PICU. Pre- and post-intervention surveys were sent to multidisciplinary PICU providers to assess effectiveness of debriefings using newly-trained leaders, as well as changes in team communication. Results Debriefing occurred after 84% (63/75) of cardiac arrests post-intervention. Providers in various team roles participated in pre-intervention (129 respondents/236 invitations) and post-intervention (96 respondents /232 invitations) surveys. Providers reported that frequently occurring debriefings increased from 9 to 58%, pre- and post-intervention respectively ( p  < .0001). Providers reported frequent identification and discussion of learning points increased from 32% pre- to 63% post-intervention. In the 12 months post-intervention, 62% of providers agreed that the overall quality of communication during arrests had improved, and 61% would be more likely to request a debriefing after cardiac arrest. Conclusion The introduction of a fellow-led debriefing tool resulted in regularly performed debriefings after arrests. Despite post-intervention debriefings being led by newly-trained facilitators, the majority of PICU staff expressed satisfaction with the quality of debriefing and improvement in communication during arrests, suggesting that fellow facilitators can be effective debrief leaders.

• Publisher: BioMed Central,BioMed Central Ltd,BMC
• Subject: Analysis / Cardiac arrest / Cardiopulmonary resuscitation / Care and treatment / Career choice / Child / Child health / Child, Preschool / Clinical Competence / Curriculum / Education / Female / Formative Feedback / Heart Arrest - therapy / Humans / Infant / Intensive Care Units, Pediatric / Interprofessional Relations / Male / Medical Education / Organizational communication / Patient Care Team / Pediatric cardiology / Pediatric intensive care / Pediatrics / Peer Group / professional education and development / Quality Improvement / Research Article / Services / Theory of Medicine/Bioethics / United States