Perioperative Critical Incident Responses at a Major Trauma Center: Baseline Assessment, Adaptive Program...

Area of Science:

• Anesthesiology
• Medical Education
• Patient Safety

Background:

• Clinical critical incidents in anesthesiology can negatively impact clinician well-being.
• Post-incident debriefing is crucial for staff support and patient safety.
• Implementing debriefing programs in high-acuity settings presents unique challenges.

Purpose of the Study:

• To assess baseline post-critical incident practices.
• To develop and implement a context-adapted debriefing program.
• To evaluate the program's integration and impact on clinician well-being and safety.

Main Methods:

• Mixed-methods study involving baseline surveys and focus groups.
• Surveys measured psychological safety, prior incident experiences, and debriefing practices.
• Post-implementation evaluation used surveys and focus groups to assess perceived impacts and barriers.

Main Results:

• Baseline survey showed high psychological safety but logistical barriers and ambiguous debriefing purposes.
• Post-program, duty relief increased significantly (27% to 64%), with most staff feeling supported.
• Critical incidents had adverse professional (52%) and personal (37%) impacts, yet potential for professional growth (48%) was identified.

Conclusions:

• A stakeholder-informed, contextually adapted debriefing program is feasible and acceptable.
• The program may mitigate adverse effects of critical incidents and foster professional growth.
• Challenges include logistics, balancing well-being with clinical review, and career-stage differences.