“Hot Debriefs” are interactive, structured team dialogues that take place either immediately or very shortly after a clinical case. They are designed to help the whole team learn from the experience, reflect on what went well, identify team strengths or difficulties and to consider ways to improve future performance.
Over 2 years ago, we decided to introduce Hot Debriefs into our ED for Resuscitation cases. There was a lack of suitable models in the clinical literature and we found no examples of other departments who performed structured, regular Hot Debriefs for such cases. We therefore set up a multidisciplinary focus group that included a wide variety of staff from within our ED and from the Scottish Centre for Simulation and Clinical Human Factors (SCSCHF), as part of NHS Education Scotland. Working together, we refined our concept to produce our “STOP5: STOP for 5 Minutes” model.
STOP5: “STOP for 5 Minutes” Hot Debrief Model
We currently seek to perform STOP5 Hot Debriefs for the following case types: deaths in Resus, Enhanced or Code Red Trauma, prehospital (Medic One) callouts, or upon request by any member of the Resus team (i.e. staff-triggered).
In our 6-month review, 90% of staff respondents rated the model as excellent, very good or good. 73% thought that the optimum time for Hot Debriefs was up to 5 minutes. Video-analysis of 15 consecutive Hot Debriefs showed that this was achievable, with a mean HDB time of 5.5 minutes. The majority of our staff felt confident both initiating and contributing to our HDB discussions. At 18 months post-introduction, 98% of respondents believed that we should do even more Hot Debriefs in our ED, highlighting that they remain highly valued by our team.
Hot Debrief Poster 1, European Society for Emergency Medicine conference, 2018
Hot Debrief Poster 2, European Society for Emergency Medicine conference, 2018
We are keen for Hot Debriefs to become more commonplace in Emergency Departments. Many departments have already contacted us to ask if they can use our STOP5 model in their own settings. Our answer is always “Yes!” If doing so, please ensure that our STOP5 framework is referenced on any materials and, if adaptions are made, ensure our original model is referenced on any posters, presentations, manuscript and publications, etc. Thank you. We are very happy to provide pdf and editable text versions so that you can customise criteria and storage locations, etc. for your own departments. Contact craigawalker@nhs.net. We are keen for your feedback and hope you experience as much success with Hot Debriefs in your departments as we have in ours.
Drs Craig Walker, Laura McGregor & Sara Robinson