Skip to main content

Table 2 HIT debriefing for implementation using the Consolidated Framework for Implementation Research (CFIR) Framework

From: A novel in situ simulation framework for introduction of a new technology: the 3-Act-3-Debrief model



Debriefing outline

CFIR domain [construct]

Act One

Introduce HIT in the context of usual workflow

Ensure shared mental model of septic patient

Outer setting [Patient needs]

For patients at risk for deterioration, telehealth can help team observe the patient using the cart. What is the reality of the workflow at this point?

Inner setting [Structural Characteristics, Implementation Climate]

Explore roles—who would set up the cart?

Intervention [Complexity]

Have participants demonstrate physical maneuvers of cart

Intervention [Complexity]Individuals [Knowledge and Beliefs]

Telehealth RN (in person) demonstrates activating cart—introduces responding eICU nurse

Intervention [Complexity]Inner setting [Networks and Communications]

Learners demonstrate activating cart

Intervention [Complexity]Individuals [Self-Efficacy]

Learners interact with telehealth nurse via cart

Intervention [Complexity]

Act Two

Identify anticipated barriers to

HIT use

Ensure shared mental model of severe sepsis

Outer Setting [Patient Needs]

Explore ED context for using telehealth cart

Inner Setting [Implementation Climate] Individuals [Knowledge and Beliefs]

Explore any prior experience with telemedicine HIT

Intervention [Complexity]                                                              Individuals [Knowledge and Beliefs]

When would this be helpful?

Inner Setting [Implementation Climate]                                          Individuals [Knowledge and Beliefs]

Intervention [Relative Advantage]

What would make it difficult?

Intervention [Complexity]

Act Three

Explore relevance, communication strategies and clinical pearls

Ensure shared mental model of septic shock

Outer Setting [Patient Needs]

Telehealth interactions: telephone vs video monitoring

Intervention [Complexity]

Point-of-contact? (MD vs RN)

Inner Setting [Networks and Communications] Intervention [Relative Advantage]

Communication strategies—in front of patient and/or families?

Inner Setting [Culture]                                                                    Individual [Knowledge and Beliefs]

Conflicting views—how to address (TeamSTEPPS tools)

Inner Setting [Culture]Individual [Knowledge and Beliefs]

The Sepsis Hospital Concept (eICU capabilities and limits)

Intervention [Relative Advantage]

Wrap up: balancing barriers vs benefits

Intervention [Relative Advantage, ComplexityProcess [Reflect and Evaluate]

  1. Lists goals, outlines descriptions, and corresponding CFIR domain for each debriefing ACT within the sepsis telehealth in situ simulation