Feedback, reflection and team learning for COVID-19: development of a novel clinical event debriefing tool

• Published in: BMJ simulation & technology enhanced learning Vol. 7; no. 1; pp. 54 - 57
• Main Authors: Welch-Horan, T Bram, Lemke, Daniel S, Bastero, Patricia, Leong-Kee, Susan, Khattab, Mona, Eggers, Jeannie, Penn, Cassidy, Dangre, Arjun, Doughty, Cara B
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-01-2021; BMJ Publishing Group
• Subjects: Communities of practice; Coronaviruses; COVID-19; Emergency medical care; Hospitals; In Practice Report; Intensive care; Leadership; Medical personnel; Pandemics; Patients; Pediatrics; Personal protective equipment; Quality control; Social networks; Teams; Virtual communities; patient safety; reflective practice; crew resource management; debriefing; quality improvement
• ISSN: 2056-6697; 2056-6697
• DOI: 10.1136/bmjstel-2020-000638

In addition to placing a complicated set of demands on governments, health systems, hospitals and individual healthcare workers, this outbreak also serves as ‘an opportunity to gain important information, some of which is associated with a limited window of opportunity’.1 In rapidly evolving pandemics, the imperative to improve performance creates an urgent need for what Amy Edmondson has described as ‘Execution-as-Learning’, a framework in which teams of front-line providers problem solve on the fly, rather than waiting for answers from leadership.2 For many front-line care providers, this threat has created unique challenges, including rapidly evolving information about presentation and management of disease, surges of patients who are critically ill, shortages of personal protective equipment (PPE) and other resources and risks to personal safety. Because of the need to disseminate both solutions found and problems encountered in a particular clinical situation to the rest of our institution, data about the event are gathered for quality improvement purposes. In recent years, ‘virtual communities of practice’ have expanded throughout healthcare and medical education, facilitating rapid innovation and creative problem solving.5 A bright spot in the otherwise bleak landscape of the COVID-19 crisis has been the growth of social media-based communities rapidly exploring problems such as translational simulation while maintaining physical distancing; the development of new workflows for high-risk clinical activities such as intubation; and educational materials for the rapid orientation of staff deployed outside of their usual clinical areas.