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Implementation of a Multidisciplinary Debriefing Process for Pediatric Ward Deterioration Events
Meghan M Galligan1,2,3, Heather A Wolfe2,4, Kelly E Papili5
1Departments of Pediatrics, galliganm@chop.edu.
Hospital Pediatrics
|April 16, 2021
Summary
Pediatric ward teams improved patient safety through a new debriefing process for intensive care unit (ICU) transfers. Adoption varied by clinician type, with dedicated frontline clinicians (FLCs) showing higher participation.
Area of Science:
- Pediatric critical care medicine
- Patient safety and quality improvement
- Healthcare systems and management
Background:
- Event debriefing is crucial for patient safety but poorly understood in pediatric wards.
- Hospitals are restructuring debriefing processes for ward deterioration events leading to ICU transfers to enhance safety.
Purpose of the Study:
- To describe the implementation and adoption of a restructured multidisciplinary debriefing process for pediatric ward events requiring ICU transfer.
- To identify factors influencing the adoption of this new debriefing protocol.
Main Methods:
- A multimethod analysis was employed, utilizing facilitative guides completed by participants.
- Monthly debriefing completion rates served as the primary metric for adoption.
- Qualitative analysis explored themes emerging from debriefing discussions.
Main Results:
- Debriefing occurred for 43% of 312 ICU transfers between March 2019 and February 2020, with bedside nurses being the most frequent participants.
- Units with dedicated frontline clinicians (FLCs) demonstrated significantly higher debriefing completion rates (57%) compared to units with rotational FLCs (33%).
- Qualitative analysis revealed that teaming activities, particularly communication, were the most frequently cited debriefing themes.
Conclusions:
- The implementation of a multidisciplinary debriefing process for ward deterioration events showed differential adoption based on provider type and FLC staffing models.
- Dedicated FLC staffing models were associated with higher debriefing adoption.
- Future research will focus on evaluating the impact of this debriefing process on patient safety outcomes.
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