Aims The general paediatric team at our hospital provides secondary paediatric care as well as tertiary and quaternary services. Our inpatient numbers vary from 40 to 120 across 15 wards. Our team comprises of over 20 junior members with varying levels of training needs. We are thus challenged to provide safe high quality patient care while maintaining situational awareness and addressing trainee needs.
Briefing and debriefing are important tools used in other safety critical industries with some data from within healthcare. Our aim was to analyse if the introduction of a structured briefing and debriefing would effect the number of supervised learning events (SLEs), non-ward based work (such as clinic letters), attendance at educational meetings, team morale and perceived consultant situational awareness.
Methods This prospective study ran over six weeks, with alternate weeks of briefing and not briefing (control). Briefings occurred after the morning handover and debriefings before the evening handover.
At briefing, white boards were used to answer pre-defined questions regarding trainee need for SLEs, identification of educational opportunities and situational awareness issues (such as staff numbers). At debriefing, the team compared the outcomes with aims, and suggestions for improvements were carried forward.
We obtained qualitative data from consultants using a SWOT analysis. The junior team completed anonymised questionnaires daily. The questions used Likert scaling and ‘Yes/No’ responses with an opportunity for free text.
Results The qualitative feedback was generally positive. Overall, more SLEs were completed during briefing weeks:
More aims were met during briefing weeks:
Team morale, colleague support and situational awareness were rated as being higher during briefing compared with non-briefing weeks.
Conclusions The introduction of briefing and debriefing space improved learning needs even when service demands were high. The exploration of reasons for not completing SLEs lead to better awareness of how to improve this. We now plan to develop our briefing tool as part of a quality improvement project to improve other outcomes such as patient flow.
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