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Baseline Well-being, Perceptions of Critical Incidents, and Openness to Debriefing in Community Hospital Emergency Department Clinical Staff
Before COVID-19, a Cross-Sectional Study
Presented by: 
(Poster pending)
Laura Cantu
Medical Student
Frank H. Netter MD School of Medicine
Laura Cantu, Listy Thomas MD MBA

Frank H. Netter MD School of Medicine


Background: This study explored providers’ perceptions of critical incidents, openness to debriefing, and well-being. Our analysis provides a baseline immediately prior to the local onset of COVID-19. The need for additional resources to support frontline providers during the pandemic can be evaluated. 

Method: We conducted a 4-week cross-sectional study prior to the first local COVID-19 case using a survey offered to interprofessional emergency department clinical staff. The main outcome measures were the Hospital Anxiety and Depression Scale (HADS) and the Professional Quality of Life (ProQOL) scale. Pearson’s chi-square test and one-way ANOVA were used to identify significant differences in perceptions of critical incidents, debriefings, and well-being between professional categories. 

Results: Thirty-nine clinical personnel responded to the survey. Events frequently selected as critical incidents were caring for critically ill children (89.7%), mass casualty events (84.6%), and death of a patient (69.2%). Additionally, 76.2% of participants reported wanting to discuss a critical incident with their team. Across all respondents, 45.7% scored borderline or abnormal for anxiety, 55.9% scored moderate for burnout, and 55.8% scored moderate to high for secondary traumatic stress.

Conclusions: At baseline, providers reported experiencing critical incidents once per week. Death of a patient occurs at increased frequency during the protracted mass casualty experience of COVID-19 and threatens provider well-being. Receptiveness to post-event debriefing is high but the method is still underutilized. With nearly half of staff scoring borderline or abnormal for anxiety, burnout, and secondary traumatic stress at baseline, peer support measures should be implemented to protect frontline providers’ well-being during and after the pandemic.


Keywords: peer support, debriefing, well-being

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