Our current process asks for you to contact the office if the incident that has occurred meets the threshold for a Datix or a Safeguarding needing to be raised. In addition, if an incident occurs that does not meet these thresholds please still call the office at the end of your shift to report the incident. The office staff member will ask you a few questions, that should not last any longer than a few minutes, will provide a level 1 debrief (details below) and will offer you the opportunity for a level 2 debrief (details below) or a clinical welfare call if required. Incident reporting forms within packages should still be completed as standard.
As a service, we offer 3 different types of debrief, the details of which are explained below.
Level 1 safety debrief – during and immediately after an incident
A Level 1 debrief should occur at the time you have reported the incident. There is an expectation that you will receive a safety debrief after every incident within a client package that is reported. This can be completed by nurse shift leads, care coordinators, clinical leads, a clinician on call, a business manager on call or out of hours staff members. At the end of your Level 1 debrief you will be offered the option to receive a level 2 debrief.
Level 2 debrief – after action review
A Level 2 should occur/be scheduled within 72 hours of the incident. The After-Action Review (AAR) process is an evidence-based structured approach to undertaking a de-brief and constructive way of identifying lessons identified from the incident. An AAR is constructed of 4 questions. AARs will be conducted by a facilitator, who was not involved in the incident and to ensure that an open discussion is held. The following individuals within the service are trained facilitators: clinical leads, clinicians on call and care coordinators. An AAR must occur within 72 hours of an incident occurring. If your package clinical lead is not the facilitator please be reassured that they will receive the full details of the incident, the debrief and any follow up actions that are required.
If you have requested a level 2 debrief (for the one reported incident) a facilitator will attempt to schedule this with you up to a maximum of 3 times. If they do not receive a response after the 3rd attempt then the request will be closed.
Level 3 debrief – critical incident debrief
A Level 3 should occur within 4 weeks of the incident. If a clinical lead felt that an action from a level 2 debrief was that a further debrief was required, each staff member involved in the incident either directly or as a witness will be offered a group critical incident debrief within 4 weeks of the incident occurring. During the debriefing meeting, you can discuss the interventions and your own behaviours. It is not a complaint session or an opportunity to tell people what they may have done wrong, but instead is constructive dialogue on how to improve future crisis interventions. The critical incident stress debriefing step by step process will be followed for all group debriefs.