Effect of Critical Incident Stress Debriefings on Provider Wellbeing after Adverse Events in the Department of Obstetrics and Gynecology at a Single Tertiary Care Hospital
Critical incident stress debriefings (CISDs) were established at this
institution in response to critical events. In this cross-sectional qualitative
study, we aim to understand the impact of CISDs on provider well-being after an
adverse outcome.The study population included 25 physicians, resident physicians, and
nurse-midwives who participated in debriefings since their introduction in 2019
within the Department of Obstetrics and Gynecology at a single tertiary care
hospital. An anonymous survey was sent to the study population with a response
rate of 72% (n = 18). The majority of survey questions were positive statements
regarding the beneficial effect of the CISD on provider well-being, and these
statements were agreed with or strongly agreed with between 61.1% to 88.9% of
the time. Of note, all of the responses that disagreed or strongly disagreed
with these statements were from faculty participants. The one faculty member
that disagreed with all positive statements responded that he/she sought
additional support following this debriefing. None of the participants
responded that the debriefing was a burden.Overall,
the CISD was found to have a positive effect on provider well-being after adverse
outcomes, especially in the resident physician group.
References
[1]
Adinma, J. (2016). Litigations and the Obstetrician in Clinical Practice. Annals of Medical and Health Science Research, 6, 74-79. https://doi.org/10.4103/2141-9248.181847
[2]
American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine, Kilpatrick, S. K., & Ecker, J. L. (2016). Severe Maternal Morbidity: Screening and Review. American Journal of Obstetrics and Gynecology, 215, B17-B22. https://doi.org/10.1016/j.ajog.2016.07.050
[3]
Edrees, H., Connors, C., Paine, L. et al. (2016). Implementing the RISE Second Victim Support Programme at the Johns Hopkins Hospital: A Case Study. BMJ Open, 6, e011708. https://doi.org/10.1136/bmjopen-2016-011708
[4]
Engel, K. G., Rosenthal, M., & Sutcliffe, K. M. (2006). Residents’ Responses to Medical Error: Coping, Learning, and Change. Academic Medicine, 81, 86-93. https://doi.org/10.1097/00001888-200601000-00021
[5]
Everly Jr., G. S., & Boyle, S. H. (1999). Critical Incident Stress Debriefing (CISD): A Meta-Analysis. International Journal of Emergency Mental Health, 1, 165-168.
[6]
Gray, M. J., Litz, B. T., & Papa, A. (2006). Crisis Debriefing: What Helps, and What Might Not. Current Psychiatry, 5, 17-29.
[7]
Harrison, R., & Wu, A. (2017). Critical Incident Stress Debriefing after Adverse Patient Safety Events. The American Journal of Managed Care, 23, 310-312.
[8]
Heiss, K., & Clifton, M. (2019). The Unmeasured Quality Metric: Burn out and the Second Victim Syndrome in Healthcare. Seminars in Pediatric Surgery, 28, 189-194. https://doi.org/10.1053/j.sempedsurg.2019.04.011
[9]
McCabe, O. L., Everly Jr., G. S., Brown, L. M. et al. (2014). Psychological First Aid: A Consensus-Derived, Empirically Supported, Competency-Based Training Model. American Journal of Public Health, 104, 621-628. https://doi.org/10.2105/AJPH.2013.301219
[10]
Merandi, J., Liao, N., Lewe, D. et al. (2017). Deployment of a Second Victim Peer Support Program: A Replication Study. Pediatric Quality and Safety, 2, e031. https://doi.org/10.1097/pq9.0000000000000031
[11]
Pettker, C. M. (2017). Systematic Approaches to Adverse Events in Obstetrics, Part II: Event Analysis and Response. Seminars in Perinatology, 41, 156-160. https://doi.org/10.1053/j.semperi.2017.03.004
[12]
Robertson, J. J., & Long, B. (2018). Suffering in Silence: Medical Error and Its Impact on Health Care Providers. Journal of Emergency Medicine, 54, 402-409. https://doi.org/10.1016/j.jemermed.2017.12.001
[13]
Scott, S. D., Hirschinger, L. E., Cox, K. R. et al. (2009). The Natural History of Recovery for the Healthcare Provider “Second Victim” after Adverse Patient Events. BMJ Quality & Safety, 18, 325-330. https://doi.org/10.1136/qshc.2009.032870
[14]
Scott, S. D., Hirschinger, L. E., Cox, K. R. et al. (2010). Caring for Our Own: Deploying a Systemwide Second Victim Rapid Response Team. The Joint Commission Journal on Quality and Patient Safety, 36, 233-240. https://doi.org/10.1016/S1553-7250(10)36038-7
[15]
Tuckey, M. R., & Scott, J. E. (2014). Group Critical Incident Stress Debriefing with Emergency Services Personnel: A Randomized Controlled Trial. Anxiety, Stress & Coping, 27, 38-54. https://doi.org/10.1080/10615806.2013.809421
[16]
Wienke, A. (2013). Errors and Pitfalls: Briefing and Accusation of Medical Malpractice—The Second Victim. GMS Current Topics in Otorhinolaryngology—Head and Neck Surgery, 12.
[17]
Wu, A. W. (2000). Medical Error: The Second Victim. The Doctor Who Makes the Mistake Needs Help Too. BMJ, 320, 726-727. https://doi.org/10.1136/bmj.320.7237.726
[18]
Wu, A. W., & Steckelberg, R. C. (2012). Medical Error, Incident Investigation and the Second Victim: Doing Better but Feeling Worse? BMJ Quality & Safety, 21, 267-270. https://doi.org/10.1136/bmjqs-2011-000605