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Methods: With ICU support, ward leaders manage (1) immediate debriefing for all ICU escalation events, and (2) delayed debriefing for severe events or any event upon ward team request. Using a multi-method approach, we analyzed facilitative debriefing guides completed by ward participants. For each unit, we mapped immediate debriefing guides from pediatric ICU transfers to a list of all pediatric ICU transfers occurring after process implementation. We generated monthly debriefing completion as an adoption metric. This served as the primary outcome in our univariate analyses. As a secondary outcome, we generated a proportion of immediate debriefs with front line clinician (FLC) participation as compared to the total number of immediate debriefs per month.

Results: Between 03/2019 and 02/2020, 137 immediate and 19 delayed debriefs were completed. Bedside nurses participated most frequently (88% of …