Table 1 COVID-related changes affecting clinical behaviour, their implications for CD, solutions and opportunities

Infection control measures prior to all clinical interactions

Task management

Potential patient care delay

Emotional consequences, complex CD

Debrief supported by expert facilitators

Wearing PPE

Visual and auditory limitations

Teams separate at the time of removing PPE (doffing)

Early planning of debriefing

Pre-set regular debriefing

Agree CD time during team briefing

Team distribution

Teamwork

Divided teams and isolated clinical areas, different COVID exposure

Virtual (online) debriefing

Staff shortages

Sickness, self-isolation, shielding

Increased workload

Lack of time

Exhaustion

Gain institutional support to prioritise safety behaviours such as CD

Engage staff by sharing the purpose and benefit of debriefing

Short and structured debriefing

Redeployment

Increased critical care demand

Reorganisation of services

Collaborate with debriefing experts

Embed new safety practice (debriefing)

Promote resilience

Leadership challenges

Shifting goals and guidelines, staff uncertainty

Identification of needs via debriefing

Reinforcement of good practice

Limited direct contact with patient, relatives and staff

Situation awareness

Hindered information gathering

Stress and frustration

Ensure psychological safety:

supportive/empathetic debriefing

Changes to practice and environment

Rapid change, need to gain familiarity with new ways of working

Opportunity for meaningful interprofessional engagement with CD

Self-awareness

Reduced resilience

Stress and exhaustion

Highlight wellbeing benefits of supportive debriefing

Changes to diagnostic and treatment options

Decision-making

Available/accessible resources

Changes to local guidelines might generate self-doubt

Risk v benefit during pandemic

Online multi-professional

Debriefing to align decisions

Share debriefing outcomes

Consider the long term