Implementation of Post Event Debriefing in the Neuroscience Intensive Care Unit

Abstract

Problem: The Neuroscience Intensive Care Unit (Neuro ICU) team frequently performs emergent resuscitation procedures. Debriefing is a form of learning in which everyone involved reflects on performance and plans on improvement. The Neuro ICU does not have a standardized procedure to debrief after patient resuscitation events. Purpose: The purpose of this quality improvement (QI) project was to implement a structured debriefing program utilizing a debriefing tool for Neuro ICU team members after all medical resuscitation events, including emergency intubations, cardiac arrests, acute changes in patient neurologic status, and any other significant patient events. Methods: The QI project was implemented in the Neuro ICU at an urban academic medical center. The project was implemented over a 14-week period. During the first 2 weeks, education about the process of debriefing and the debriefing tool occurred. Over the next 12 weeks the team implemented the project, which included tracking utilization of the tool after each event. The data were analyzed with descriptive statistics, such as percentage of debriefings competed each week. Results: The Neuro ICU team completed 28 debriefings utilizing the debriefing tool. There was an 80% increase in debriefings, compared to 0% debriefings before the project. Conclusions: Implementation of the new debriefing process has helped the Neuro ICU team to to identify areas and strategies for improvement in patient care, promoted communication between team members, and enhanced their clinical knowledge. Utilization of the Critical Event Debriefing tool created a structure to the debriefing process. To promote sustainability of the project, continuous engagement and support from the project champions, as well as promotion and expansion of the project to other units of the hospital are considered as future strategies.