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Review
. 2020 Dec;38(4):801-820.
doi: 10.1016/j.anclin.2020.08.003. Epub 2020 Oct 13.

Real-Time Debriefing After Critical Events: Exploring the Gap Between Principle and Reality

Alexander F Arriaga  1 , Demian Szyld  2 , May C M Pian-Smith  3
Affiliations
Review

Real-Time Debriefing After Critical Events: Exploring the Gap Between Principle and Reality

Alexander F Arriaga et al. Anesthesiol Clin. 2020 Dec.

Abstract

Debriefing after perioperative crises (eg, cardiac arrest, massive hemorrhage) is a well-described practice that can provide benefits to individuals, teams, and health systems. Debriefing has also been embraced by high-stakes industries outside of health care. Yet, in studies of actual clinical practice, there are many critical events that do not get debriefed. This article explores the gap that exists between principle and reality and the factors and strategies to offer opportunities to reflect on actual critical events, when indicated, across the increasing scope of environments where anesthesia care is provided.

Keywords: Crew/crisis resource management; Critical event debriefing; Debriefing; Feedback; Implementation science; Medical education; Medical simulation; Patient safety.

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Conflict of interest statement

Disclosure A.F. Arriaga is the recipient of a mentored research training grant from the Anesthesia Patient Safety Foundation and the Foundation for Anesthesia Education and Research. He is the recipient of a Career Development Award from the Center for Diversity and Inclusion of the Brigham and Women’s Hospital. He is a member of the Patient Safety Editorial Board for the American Society of Anesthesiologists and Question Editor for the American Board of Anesthesiology, where he receives a stipend for work that is otherwise done in a volunteer capacity. D. Szyld is the Senior Director for the Simulation Education Program of the Center for Medical Simulation. The Center for Medical Simulation provides courses and consulting to individuals and institutions in the areas of teamwork, crisis resource management, simulation-based education and debriefing. M.C.M. Pian-Smith is on the Board of Directors of both the Anesthesia Patient Safety Foundation and the Foundation for Anesthesia Education and Research. She is Adjunct Faculty for the Center for Medical Simulation. The Center for Medical Simulation provides courses and consulting to individuals and institutions in the areas of teamwork, crisis resource management, simulation-based education and debriefing.

Figures

Fig. 1
Fig. 1
Five foundational categories of implementation science.
Fig. 2
Fig. 2
Critical steps of implementation as part of a quality improvement framework.
Fig. 3
Fig. 3
The PEARLS (promoting excellence and reflective learning in simulation) health care debriefing tool. (A): Front; (B): Back.
Fig. 4
Fig. 4
The DISCERN (debriefing in situ conversation after emergent resuscitation) tool.
Fig. 5
Fig. 5
Neonatal resuscitation algorithm (American Heart Association. 2015 update).
See this image and copyright information in PMC

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