2025 Community of Human and Organizational Learning 31st Annual Conference

Background
Resilient teams are the foundation of high-performing, patient-centered care in the Emergency Department (ED). In the high-acuity environment of the Comer Pediatric ED, increasing patient volume and complexity have highlighted the need for stronger teamwork, communication, and psychological safety. To address these challenges, the ED implemented cold debriefs—structured post-event discussions designed to support team learning, emotional resilience, and process improvement. These debriefs provide frontline staff with a safe space to reflect, learn from both successes and failures, and drive meaningful system changes.
Methods
A structured cold debriefing process was introduced to strengthen human and organizational resilience:
• Psychological Safety & Team Support: Creating a non-punitive space for staff to process high-stress events, share experiences, and voice concerns.
• Multidisciplinary Collaboration: Bringing together nurses, providers, and ED leaders to discuss challenges, decisions, and system-level improvements.
• Structured Learning Approach: Using event categorization (trauma, resuscitation/ROSC/death, critical sepsis, and other high-risk cases) to identify common themes and improvement opportunities.
• Data-Driven Reflection & Action: Tracking insights in RedCap to analyze trends, address recurring challenges, and guide system-wide safety enhancements.
• Targeted Training & Practice Changes: Translating debrief outcomes into education initiatives, workflow refinements, and resilience-building strategies.



Results
80 Cold Debriefs Conducted (2023–2024):
• 40 trauma cases
• 30 resuscitation/ROSC/death cases
• 6 critical sepsis cases
• 5 other critical cases
Key Outcomes & Team Resilience Enhancements:
• Increased Psychological Safety: Staff reported greater confidence in managing critical events and an improved sense of team support.
• Empowered Frontline Voices: Cold debriefs reinforced a culture where staff feel valued, heard, and engaged in decision-making.
• Targeted Clinical Improvements:
o Standardized Pediatric Difficult Airway Process to improve emergency response.
o Strengthened hypoglycemia prevention protocols for high-risk pediatric patients.
o Expanded NICU/OB/Trauma simulations to enhance multidisciplinary preparedness.
o Developed standardized bedside handoff tools to improve patient transitions.
o Optimized Epic workflows for streamlined documentation and triage efficiency.
• Sustained Team Learning & Adaptability: By fostering ongoing reflection and knowledge-sharing, cold debriefs have become a core component of continuous professional growth and adaptive teamwork.
• Scalability Across Units: Cold debriefing is now being integrated into all pediatric units, reinforcing a hospital-wide commitment to resilience and patient safety.
Conclusion
Cold debriefs serve as a powerful mechanism for building resilient, high-functioning teams in the emergency department. By promoting psychological safety, structured learning, and frontline engagement, they have strengthened collaboration, decision-making, and patient safety culture at Comer Children’s Hospital.