Impact of debrief
There is overwhelming evidence that organisation with engaged staff achieve better outcomes: better patient experience, fewer errors, lower infection and mortality rates, better financial management, less work absence, and less burnout(8). Our findings that debrief is associated with higher CCB scores suggests that debrief may play a role wider than just the daily session itself. Whilst we observed differences in relation to recommending team / hospital as a place to work, these were not statistically significant, and the study underpowered for that outcome.
It is disappointing that over a third of our staff did not have access to debrief. Previous research has identified theatre debrief to be an important part of a comprehensive quality improvement programme, but its implementation is not straightforward. Leadership engagement and commitment are notable driving factors, in addition to meaningful and early debriefing feedback. On the other hand, loss of institutional commitment, resources and personnel might have a negative effect(9). It is important that there is a culture of openness, trust, and a willingness to explore challenges in a supportive and non-judgemental fashion, but this is not easy to achieve. Some staff may be reluctant to engage given debrief can identify their perceived failure and may feel uncomfortable to share their feelings with others; having a culture of learning and psychological safety is therefore key.