see also: [[Disaster preparedness]] see: [ANZCA critical incident debriefing toolkit](https://libguides.anzca.edu.au/criticalincident/home) ## Hot Debrief > for "psychological first aid" > purpose is for staff well-being - immediately after incident - involve all key people voluntarily - 5-10 min session - away from where incident occurs - lead by trained facilitators, *not those involved in incident* > **OK? STOP** - *RMH debrief framework* > *OK?* > - "OK?" check in > - own the incident > > *S* > - set the scene > - salute the team > - acknowledge outcome ; everyone shows up to do a good job > - summarise the case > > *T* > - things that went well > - emphasise team performance > > *O* > - opportunities to learn > > *P* > - people first: prioritise breaks, tap outs > - Provide information: self care tips, support avenues > - ponder need for *cold de-brief* > - points for action: things needing follow up > - put in writing (RMH has a QR code for executive follow up) answer 4 key questions: 1. what was supposed to happen? 2. what actually happened? 3. why were there differences? 4. what can we learn from that? aspects: - thank staff for their efforts - deliver a summary narrative of the events that unfolded - ask if staff have any pressing matters they want to address or understand - aim to identify any staff at risk of or experiencing psychological distress - note avenues for taking leave in coming days, staff health psych services - book date for cold debrief in ~1 week ### IRASTT framework for hot debrief 1. *introduction and intention* : introduce self, set ground rules (confidentiality, support, non-judgement). "I'm proposing we take 5-10 min to commit to reflecting on the event that just occurred with an intention to xxx" 2. *reactions* phase: ask open-ended questions. "what are people's thoughts?" 3. *analysis* phase: 1. summary of situation 2. analysis: address issues raised in reactions phase. 3. explore decision making, skills, communication, use of resources and time, leadership, and teamwork 4. highlight things the team and individuals did well 5. any learnings? 4. *summary* phase: sum up and recap 5. *take home*: any outstanding issues or concerns. any actions to follow up? "the key learnings from today were xxx" 1. group discussion about how other stakeholders may be involved 6. *Thank you*: thank staff for efforts. focus is on quality improvements and outcomes for patients. 1. if there is other unresolved issues, can plan cold debrief in 5-10 days 2. remind staff acute critical stress symptoms are common and of employee assistance program and other local peer support options ## Cold debrief - ~1 week post incident - allow participants to reflect on potential lessons aspects: - recap situation - review any new clinical information that has come to light - review outcomes - ask how staff feel - identify those struggling - have staff health rep/psych available - identify areas for improvement (systems, processes, equipment, and learning needs) - review follow up