Background

There is a growing interest in understanding how to improve the performance of a medical emergency team in a healthcare contests [1,2]. Cold debriefing, carried out some time (within 7 days) after an emergency, is supposed to be a useful method [3].

Objective

The purpose of this research is to assess how post-emergency cold debriefing is perceived by health care operators and its impact on non-technical skills applied by a medical emergency team in a simulated setting.

Methods

This is a case-control study realised in two steps. During the first phase, post-emergency debriefing was planned within 7 days after an in-hospital emergency. The perception of the healthcare personnel who attended the debriefing was assessed using a targeted questionnaire with a numeric rating scale from 1 to 10. In the second phase, a group of emergency teams was evaluated concerning the non-technical skills in a simulated setting. Teams composed by healthcare operators who participated in the previous debriefing (case) were compared with teams their members did not participate in the debriefing (control). In this simulated phase the performance of any team was videotaped and subsequently evaluated by a group of blinded healthcare professionals using the previously validated TEAM score scale [4]. We enrolled a group of voluntary healthcare professionals of any role. Ethical approval was considered not necessary based on the type of the study.

Results

We realized 6 post-emergency cold debriefings involving 63 healthcare professionals. The overall perception was higher than 8 in all cases. During the debriefing we recorded a greater emotional involvement in paediatric ward and a greater risk of misunderstanding in cardiology and obstetrics wards. In the second phase the teams whose member had previously participated in the cold debriefing had practised advanced life support using non-technical skills better than the control team (mean TEAM score 7.1 ± 1.8 vs 5.9 ± 1.5; p <0.01).

Discussion

Cold post-emergency debriefing is a very important moment in the growth of a medical emergency team. Despite the risk of conflict, it allows to improve the management of any emergency team, facing with the emotional aspect. In addition, it allows to increase the non-technical skills applied during advanced life support as we have demonstrated in a simulated environment.

References

1. Fiscella K, Mauksch L, Bodenheimer T, Salas E. Improving Care Teams' Functioning: Recommendations from Team Science. Jt Comm J Qual Patient Saf. 2017; 43(7):361–368.

2. Buljac-Samardzic M, Kirti D Doekhie KD, van Wijngaarden JDH. Interventions to improve team effectiveness within health care: a systematic review of the past decade. Hum Resour Health. 2020; 18(1): 2.

3. Lyman K. The relationship between post-resuscitation debriefings and perceptions of teamwork in emergency department nurses. Int Emerg Nurs. 2021; 57:101005.

4. Cooper S, Cant R, Connell C, Sims L, Porter JE, Symmons M, Nestel D, Liaw SY. Measuring teamwork performance: Validity testing of the Team Emergency Assessment Measure (TEAM) with clinical resuscitation teams. Resuscitation. 2016; 101:97-10