Bolstering clinician resilience through an interprofessional, web-based nightly debriefing program for emergency departments during the COVID-19 pandemic

ABSTRACT

The COVID-19 pandemic has instigated significant changes for health care systems. With clinician burnout rising, efforts to promote clinician resilience are essential. Within this quality improvement project, an interprofessional debriefing program (Brigham Resilience in COVID-19-pandemic Emergency Forum-BRIEF) was developed within two emergency departments (EDs). An interprofessional group of ED providers led optional, nightly debriefings using a web-based portal to connect with ED clinicians for six weeks. In total, 81 interprofessional staff participated in nightly debriefings with a 47% attendance rate. On average, three participants attended the BRIEF nightly (range = 2–8) to discuss the challenges of social distancing, scarce resources, high acuity, clinician burnout and mental health. Participation increased as rates of COVID-19 positive patients rose. Debriefing leaders provided ED leadership with summaries of clinician experiences and suggestions for improvements. Feedback supported quality improvement initiatives within the ED and greater mental health support for staff. Clinicians and administrators provided positive feedback regarding the program’s impact on clinician morale, and clinical processes that promoted the safety and quality of patient care. Optional debriefing with receptive departmental leadership may be a successful tool to support clinicians and hospitals during critical events.

KEYWORDS:

• Debriefing
• process improvement
• clinician burnout
• resilience

Acknowledgments

The authors like to thank and recognize their clinical colleagues who display the highest degrees of professionalism and compassion as they take care of the patients and each other during the COVID-19 pandemic. The authors would like to thank Morgan Sehdev, an HMS Medical Student who created the poster for this program. They would also like to thank Sejal Shah, MD, Chief of the Division of Medical Psychiatry at BWH for her support and guidance. The authors are particularly appreciative of the ED leadership team for their receptiveness and support of their team and this program.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Additional information

Notes on contributors

Desiree R. Azizoddin

Desiree Azizoddin is a clinical psychologist and behavioral scientist serving as Research Faculty in the Department of Emergency Medicine at Brigham and Women's Hospital (BWH) and Harvard Medical School (HMS).

Kristen Vella Gray

Kristen Vella Gray is a licensed physicians assistant and provides care in the Department of Emergency Medicine at BWH.

Andrew Dundin

Andrew Dundin is a Registered nurse and also provides care in the Department of Emergency Medicine at BWH.

Demian Szyld

Demian Szyld is an Emergency Medicine physician at BWH and HMS and serves as Senior Director of the Harvard Medical Simulation Center.