Leadersh Health Serv (Bradf Engl)
Institute for Quality Improvement, World Academy of Medical Leadership, Sheffield, UK and QiMET International, Sheffield, UK.
Published: March 2022
Purpose: The purpose of this paper is to re-conceptualise the hot debrief process after cardiac arrest as a collaborative and distributed process across the multi-disciplinary team. There are multiple benefits to hot debriefs but there are also barriers to its implementation. Facilitating the hot debrief discussion usually falls within the remit of the physician; however, the American Heart Association suggests "a facilitator, typically a health-care professional, leads a discussion focused on identifying ways to improve performance". Empowering nurses through a distributed leadership approach supports the wider health-care team involvement and facilitation of the hot debrief process, while reducing the cognitive burden of the lead physician.
Design/methodology/approach: A mixed-method approach was taken to evaluate the experiences of staff in the Emergency Department (ED) to identify their experiences of hot debrief after cardiac arrest. There had been some staff dissatisfaction with the process with reports of negative experiences of unresolved issues after cardiac arrest. An audit identified zero hot debriefs occurring in 2019. A quality Improvement project (Model for Healthcare Improvement) used four plan do study act cycles from March 2020 to September 2021, using two questionnaires and semi-structured interviews to engage the team in the design and implementation of a hot debrief tool, using a distributed leadership approach.
Findings: The first survey ( = 78) provided a consensus to develop a hot debrief in the ED (84% in the ED; 85% in intensive care unit (ICU); and 92% from Acute Medicine). Three months after implementation of the hot debrief tool, 5 out of 12 cardiac arrests had a hot debrief, an increase of 42% in hot debriefs from a baseline of 0%. The hot debrief started to become embedded in the ED; however, six months on, there were still inconsistencies with implementation and barriers remained. Findings from the second survey ( = 58) suggest that doctors may not be convinced of the benefits of the hot debrief process, particularly its benefits to improve team performance and nurses appear more invested in hot debriefs when compared to doctors.
Research Limitations/implications: There are existing hot debrief tools; for example, STOP 5 and Take STOCK; however, creating a specific tool with QI methods, tailored to the specific ED context, is likely to produce higher levels of multi-disciplinary team engagement and result in distributed roles and responsibilities. Change is accepted when people are involved in the decisions that affect them and when they have the opportunity to influence that change. This approach is more likely to be achieved through distributed leadership rather than from more traditional top-down hierarchical leadership approaches.
Originality/value: To the best of the authors' knowledge, this study is the first of its kind to integrate Royal College Quality Improvement requirements with a collaborative and distributed medical leadership approach, to steer a change project in the implementation of a hot debrief in the ED. EDs need to create a continuous quality improvement culture to support this integration of leadership and QI methods combined, to drive and sustain successful change in distributed leadership to support the implementation of clinical protocols across the multi-disciplinary team in the ED.
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http://dx.doi.org/10.1108/LHS-06-2021-0050 | DOI Listing |
Background: Hot debriefing occurs shortly after simulations or real-life events, whereas cold debriefings occur after 24 hours. This integrative review examined the effects of hot versus cold debriefing after simulation on prelicensure students.
Method: Whittemore and Knafl's five-stage method was followed.
Glob Adv Integr Med Health
September 2024
Department of Medicine, Weill Cornell Medicine, Cornell University, New York, NY, USA.
Background: Research on Qi Gong (QG) supports promising health benefits. Both interest and use of QG in U.S.
View Article and Find Full Text PDFAdv Ther
August 2024
Sumitomo Pharma Switzerland GmbH, Aeschengraben 27, 4051, Basel, Switzerland.
Introduction: This qualitative research study was conducted to develop a novel, comprehensive, patient-reported outcome measure (PRO), the "Symptoms and Impacts of Androgen Deprivation Therapy (ADT) for Prostate Cancer" (SIADT-PC), assessing hormonal therapy-related symptoms and their impacts on men with advanced prostate cancer.
Methods: Concept elicitation (CE) interviews were conducted among adult men with prostate cancer to evaluate their experiences with ADT. Based on key symptom and impact concepts mentioned, an initial PRO measure was developed.
Jt Comm J Qual Patient Saf
September 2024
The pandemic has intensified clinicians' workloads, leading to an increased incidence of adverse events and subsequent second victim syndrome, with almost half of health care clinicians experiencing its symptoms. However, following a literature review, no tools were found that addressed second victim syndrome in nurses. To address these issues and the gap in the literature, the authors developed the BONE Break hot debriefing tool.
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