Implementation and Performance of a Clinical Debriefing Programme in a Paediatric Emergency Department: A Descriptive Qualitative Review

OBJECTIVE: Clinical debriefing should be standard practice in healthcare, but in most emergency departments implementation lags behind evidence. This post-implementation evaluation examined the performance of a clinical debriefing programme in a tertiary care paediatric emergency department, exploring implementation, key enablers and barriers to use. METHODS: This qualitative descriptive, post-implementation study used semi-structured interviews, with deductive analysis guided by a context-mechanism-outcome framework. RESULTS: Twenty-one multidisciplinary staff were interviewed. Debriefing became embedded in routine practice through organisational endorsement, structured facilitation and inclusive participation. Participants reported improved clinical reasoning, emotional regulation, psychological safety and interprofessional relationships. Debriefing strengthened support for junior staff, enhanced relational co-ordination across disciplines, facilitated more timely quality and safety actions and built nursing capacity to lead debriefs. Time was the principal barrier, but reframing debriefing as an integral component of clinical care enabled its routine delivery. CONCLUSIONS: Clinical debriefing was embedded in routine practice through interactions between organisational context and implementation mechanisms, with successful implementation relying on both the intervention and the conditions enabling it. Benefits for clinical practice, staff well-being, teamwork, enhanced support for the junior workforce and timely quality improvement initiatives were described. This study advances current understanding and provides direction for teams seeking to implement or optimise debriefing within their own departments.