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DEBRIEFING
AND
CARDIAC ARREST
QUALITY
IMPROVEMENT
OBJECTIVES
PROBLEMS AT A GLANCE PART 1
PROBLEMS AT A GLANCE PART 2
SURVIVAL TO DISCHARGE
“IS ALL OVER THE MAP”
DEVELOPING A CULTURE OF
EXCELLENCE
BASTARD
LIFESAVERS
I HATE
WAITING! DAMN EMTS
A NECESSARY COMBINATION!
DEBRIEFING IS CHEAP!
Debriefing of cardiac arrest events, either
in isolation or as part of an organized
response system, improves subsequent
CPR performance in-hospital and results in
higher rate of return of spontaneous
circulation (ROSC).
Debriefing of actual resuscitation events
can be a useful strategy to improve
future performance (Class IIa, LOE C).
Innovative concepts to reduce the decay of
skills and knowledge may include continuous
maintenance of competency programs that
employ frequent short-duration interactions
with content and skills after an initial course,
or they may include guided debriefings after
real-life events that focus on response
improvement.
Debriefing is a learner-focused,
nonthreatening technique to assist individual
rescuers or teams to reflect on, and improve,
performance. In manikin-based studies,
debriefing as part of the learning strategy
resulted in improved performance in
post-debriefing simulated scenarios, and it
improved adherence to resuscitation
guidelines in clinical settings.
Debriefing as a technique to facilitate
learning should be included in all advanced
life support courses (Class
I, LOE B).
Our Definition!
A provider‐centric process
designed to standardize the
debriefing process to assist
clinicians in thinking about what
they did, how they did it, and how
they can improve.
Structured and Supported Debriefing
A provider-centered approach
emphasizes self-discovery and
self-critique.
A provider-centered
approach also draws upon
professional experience and
motivation to perform well to
enhance performance and
outcomes.
Thoughtful discussion after an attempted
resuscitation is important to facilitate the
sorting out of events as well as gaining
insight on what happened and why
We often learn better through self‐discovery
and self‐analysis than by other methods!
PROVIDERS NEED TO
EXPRESS
THEMSELVES AND
THEIR FEELINGS…
AND THIS IS A GREAT
FORUM FOR THAT!
•Have long term view
•Patients and patience
•INSTANT GRATIFICATION!
IMPLEMENTATION
Supported elements include both interpersonal
support as well as use of protocols, algorithms, and
best evidence to inform debriefing
statements/questions.
Structured and Supported Debriefing
Structured elements include three specific debriefing
phases with related goals, actions, and time
estimates.
Structured and Supported Debriefing
Debriefing and QI Compressed
Team leader
trained in
Structured
and
Supported
Debriefings
ROLE OF FACILITATOR
•PROVIDE SAFE ENVIRONMENT FOR
SHARING EXPERIENCES
•DRAW OUT INFORMATION AND
EXPERIENCES
•CONTENT DIRECTED BY THE CREW
•NEVER JUDGE!
Debriefing and QI Compressed
Gather, Analyze, Summarize
Debriefing and QI Compressed
USE UNTAPPED
DATA!
NOT PUNATIVE!
PIZZA DIPLOMACY!
BOY, I AM
REALLY
LOOKING
FORWARD TO
THE DEBRIEFING
ON THIS CASE!
Debriefing and QI Compressed

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