Moving on from Huddles to briefing and debriefing….
Briefings are short gatherings at the beginning of either a day, a shift, a clinic or session; basically any duration of event or time that involves working as a team. They can also be before an action such as the removal of a central line or naso-gastric tube, at the start of a conference or at the beginning and end of training sessiona. They dont have to be ‘a call for action’ but can be used to:
- introduce everyone to each other – really important if the team individuals are different every day
- review the tasks, activities and time ahead
- check who is doing what and when
- encourage anyone to speak up before anything starts
It can take as little as 30 seconds to conduct a briefing and should be no longer than 15 minutes.
A briefing is best complimented by a debriefing at the end
They both work well if people understand that individuals will behave differently but these different roles or behaviours should be valued, respected and are all equally important:
Speakers / extroverts – those that like to speak and share their concerns outwardly – allow them to explore and talk things out, let them dive right in and let them shine
- suggest …… ask the ‘speaker’ to perhaps use a framework for ensuring they get all the information across as quickly as possible using tools like SBARR (situation, background, assessment, recommendation and response) – this may prevent the speaker from dominating the brief or debrief and keep them focused
Active listener – those that like to listen but also ask questions (on the extrovert/introvert cusp)
- suggest…… using these individuals to respectfully ask clarifying and open questions to help everyone’s understanding
Observer / introverts – those that like to listen in silence – respect their need for privacy and never embarrass them in public. Let them first observe and give them time to think (dont demand answers). Dont interrupt them when they do speak
- suggest….. they pay attention to their thoughts and feelings and if they do not feel they understand what the speaker is saying or the active listener has failed to clarify – ask them to consider pointing out at the end what has been missed or what is absent from what people need to do – give them notice of this and set this out at the beginning so that they can have time to think and gather their thoughts by the end
During the brief, the team should address the following questions:
___ Who is on the team? introductions by firstname
___ Do all members understand and agree upon goals or aims and objectives?
___ Are roles and responsibilities understood? what are we all doing
___ What is our plan of care or the plan for the shift / day / clinic or session?
___ What staff do we have available throughout the shift / clinic / session?
___ How is the workload shared among team members?
___ What resources / equipment / devices / drugs are needed and available?
___ What can we anticipate could go wrong? how will we try to mitigate against that?
The team should address the following questions during a debrief:
___ Was communication clear?
___ Were roles and responsibilities understood?
___ Was situation awareness maintained?
___ Was workload distribution equitable?
___ Was task assistance requested or offered?
___ Were errors made or avoided?
___ Were resources available?
___ What went well?
___ What should improve?
Health Quality & Safety Commission’s teamwork and communication workshop in Auckland – 18 June 2015 via https://www.youtube.com/watch?v=czTyae-R0G8
Team working tools – via http://www.ahrq.gov/professionals/education/curriculum-tools/teamstepps/instructor/essentials/pocketguide.html#passbaton
Extraversion and introversion via https://en.wikipedia.org/wiki/Extraversion_and_introversion
I enjoy your posts; they are provoking much discussion within my peer group. (We are seven regional ‘CRMs’ supporting the whole West Australian Country Health Service).
I would like to share your posts (fully referenced) via a monthly safety and quality newsletter with my health service colleagues in my Great Southern region.
Would you endorse my doing so?
Regards, Liz Kilkenny Regional Clinical Risk Management Coordinator WACHS Great Southern
of course – please share I would be delighted!
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