The Acute Incident Response Program: A Framework Guiding Multidisciplinary Responses to Acutely Traumatic or Stress-Inducing Incidents in the ED Setting

• Published in: Journal of emergency nursing Vol. 46; no. 5; pp. 579 - 589.e1
• Main Author: Pallas, Jeremy
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2020; Elsevier Limited
• Subjects: Adaptation, Psychological; Adult; Burnout; Burnout, Professional - prevention & control; Crisis Intervention - organization & administration; Critical incident; Critical incidents; Debriefing; Dissemination; Early intervention; Efficacy; Emergency; Emergency medical care; Emergency Service, Hospital - organization & administration; Emergency services; Emotional responses; Group performance; Humans; Interdisciplinary aspects; Intervention; Models, Psychological; Nursing; Occupational Health; Peer Group; Peer support; Peer tutoring; Post traumatic stress disorder; Program Development; Program Evaluation; Psychological support; Stress; Stress Disorders, Post-Traumatic - prevention & control; Stress management; Teams; Teamwork; Trauma; Traumatic stress; Nursing; Peer support; Critical incident; Emergency; Trauma; Debriefing; Stress
• ISSN: 0099-1767; 1527-2966
• DOI: 10.1016/j.jen.2020.05.016

Clinicians working in the ED setting are exposed to traumatic and stress-inducing incidents, which may increase the incidence of psychological sequelae, including burnout and acute stress disorders. The purpose of this project was to develop and implement a novel debriefing program as an early intervention for acutely stress-inducing events in the emergency department. The 2-stage Acute Incident Response program was developed and implemented in the emergency department of the John Hunter Hospital to guide an interprofessional response to acutely stress-inducing incidents. This psychological support framework draws on existing concepts of critical incident stress management along with elements of contemporary “hot debriefing” models to create a concise, clinician-led response program incorporating elements of both work group peer support and clinical team performance improvement. The Acute Incident Response program is novel in its concurrent focus on both salient clinical factors and emotional responses of affected clinicians. The developed Acute Incident Response program framework predominantly focuses on the wide dissemination of a peer-driven debriefing model. When additional support is deemed necessary by trained clinical champions after the Hot Acute Incident Response process, escalation to a central response coordinator ensures targeted secondary support follow-up for all affected team members. This program has been introduced at 1 site and warrants further targeted investigation to determine its efficacy and utility in a broad range of clinical contexts. The Acute Incident Response program is an accessible and meaningful model to guide a functional, clinician-led response to acute incidents in the ED setting. The model could feasibly be applied in a wide variety of clinical contexts.