Getting to Safe by Denys Court

Author:Denys Court [Court, Denys]
Language: eng
Format: epub
ISBN: 9781528993593
Barnesnoble:
Publisher: Austin Macauley Publishers Ltd.
Published: 2021-01-08T00:00:00+00:00

A statistical positive effect of CISM has been demonstrated. As one example, its efficacy was assessed following the sinking of a ferry in Estonia in 1997. A comparison was made between rescue personnel, fire officers, police investigators, and disaster victim investigators who were debriefed, with rescue team nurses who were not debriefed for organisational reasons. The debriefed subjects scored lower on an ‘Impact of Event’ (IES) scale than the nurses.16 In 1989 a professional debriefing was provided for one group of oil rig workers in the aftermath of a North Sea oil rig disaster. This group had no long-term negative effects, whereas a group who were not debriefed experienced significant distress.17

What can be taken from all this for the healthcare sector? It would seem there are benefits for debrief for extraordinary AEs in health where otherwise team cohesion is at risk. One such event that I well remember when I was a clinical director was an afterhours maternal death from postpartum haemorrhage. I remember the hollow feeling I felt when I was phoned and informed of the death. I was gardening at the time and I still remember where in the garden I stood and what I was wearing. Obviously the event was an absolute tragedy for the family involved – a newborn and a husband without a mother and a wife. It was also an event that caused high levels of distress amongst our labour and birth staff, our operating theatre staff, and specialists and resident staff. It was certainly the most tragic outcome that I have known in my obstetric career. The death was avoidable and from an early stage that was evident. The root cause analysis (RCA) we performed identified 36 validated recommendations – more than one would usually expect or encourage from an RCA. Thirty-two of them were found to be practicable and were implemented. The case and its learnings are quoted in our service to this day and substantial redesign of our services has benefited thousands of women since, keeping their care safer. So, from the most tragic event I have been service-responsible for to service and system improvements of which I and the team involved are very proud – a learning environment. This of course does not detract from the degree of tragedy for the family involved.

Looking back, I believe that a more expert-provided formal professional debrief would have been of substantial utility. It did not occur. Formal debriefing which has been shown to be effective requires debrief professionals. It is not a role for the occasional dabbler. That said, I do think that groups convening within a service after a major catastrophic event for what is termed debrief are still useful. I believe, without scientific proof, that it does improve team cohesion through ordinary social cohesion. Those I have talked to who have been involved state that it helped them to resist the feelings of isolation and assisted in reducing speculation. It allowed individuals to feel supported and allowed some to determine they needed individual help.

Download

Copyright Disclaimer:
This site does not store any files on its server. We only index and link to content provided by other sites. Please contact the content providers to delete copyright contents if any and email us, we'll remove relevant links or contents immediately.