An exploration and analysis on the timeliness of critical incident stress management interventions in healthcare.

There is debate in the literature regarding the definition and effectiveness of "early" critical incident stress management (CISM) interventions. Definitions range from interventions that take place within twelve hours (Everly and Mitchell, 1999; Stallard, Velleman, Salter & Howse, 2005) and up to a three month window (Bisson & Cohen, 2006). Others define early support as an intervention directly after an incident, before the individual leaves work and definitely before having their first sleep (Talbot, 1990; Snelgrove, 2000). Most CISM research is carried out in industries that do not have the same characteristics as healthcare namely, 24/7 operation and a strong female demographic. Therefore, given the lack of research evidence around the timeliness of CISM interventions in healthcare, this study examined the effect of early (< 24 hours post-incident) vs. late (> 24 hours post-incident) CISM interventions on stress reaction and employees perceptions of service. Although the subject population in each group was too small to show statistical significance, the quantitative data showed an overall trend that the early intervention group had lower mean scores for avoidance, intrusion and hyperarousal at all three time periods. Thematic analysis demonstrated both groups found the CISM intervention was beneficial and the timing appropriate.