How to lead a hot debrief in the emergency department

[Extract]
Effective team communication is a critical element of ED performance. Trainees are encouraged to develop skills in leading resuscitation and trauma teams through effective pre-briefing, recaps and handovers.

Recently, attention has turned to ‘debriefs’ – conversations that support team reflection on clinical practice. These may occur after discrete clinical events, after a shift or at other times. The impact of clinical debriefing can be powerful – by improving performance, encouraging learning and mitigating psychological distress.

As with many powerful communication techniques, there are risks. Conversations that are badly executed may fail to identify points of improvement, magnify team conflicts, exacerbate feelings of distress or simply waste time when there is work to be done. Emergency physicians and trainees may hesitate to lead clinical debriefings when they have had poor prior experiences or lack confidence in their own skills. They will find it harder to lead clinical debriefings if there is no local departmental strategy.