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. 2019 Jul 22;19(1):272.
doi: 10.1186/s12909-019-1711-y.

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

Jennifer Gillen  1   2 , Monica L Koncicki  1   3 , Rebecca F Hough  4 , Kathryn Palumbo  1 , Tarif Choudhury  4 , Ariel Daube  1   5 , Anita Patel  1   6 , Amy Chirico  1 , Cheryl Lin  1 , Sirisha Yalamanchi  1   7 , Linda Aponte-Patel  4 , Anita I Sen  8   9
Affiliations

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

Jennifer Gillen et al. BMC Med Educ. .

Abstract

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.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Cardiac Arrest Data Collection Forms; a: Cardiac Arrest Data Sheet b: Cardiac Arrest Debriefing Tool
Fig. 2
Fig. 2
Project Timeline, Frequency of Cardiac Arrest, and Debriefing Frequency. PDSA Cycle 1 (Jul 2014 – Feb 2015): Initiation of cardiac arrest data collection, creation of cardiac arrest data sheet and debriefing tool. PDSA Cycle 2 (Mar 2015 – Sep 2015): Initiation and revision of arrest data sheet and debriefing tool. PDSA Cycle 3 (Oct 2015 – Sep 2016): Implementation of finalized arrest data sheet and debriefing tool
See this image and copyright information in PMC

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