# 2.3 Resources

## **Resources & teamwork**

* **Helpful Tools:** Provide [supporting articles](/level-1-fundamentals/1.-preproduction/1.4-unburdening-the-process.md), presentations, and [FAQs](/welcome/quick-start/faqs.md).
* **Defined Roles:** Establish who manages videos, chairs reviews, etc., including a [mix of disciplines](/level-1-fundamentals/2.-planning-your-initiative/2.1-pioneer-team.md) for a well-rounded team.
* **Provider Control:** Voluntary participation and [consent at multiple stages](https://github.com/LennartvdM/NFLX-nieuwe-structuur/blob/main/level-1-fundamentals/3.-safe-simple-and-small#safe-obtaining-consent) keeps providers in control of their participation.
* **Addressing Concerns:** Listen actively and provide honest, transparent responses.
* **Collaborative Spirit:** Involve all relevant staff when scheduling reviews. Management support reinforces the initiative's importance.

## Tips & tricks

<table data-view="cards"><thead><tr><th></th><th></th><th></th></tr></thead><tbody><tr><td><p><strong>Streamline Recording:</strong></p><p><a href="https://github.com/LennartvdM/NFLX-nieuwe-structuur/blob/main/level-2-in-action/8.-recording-during-the-intervention">Minimize the number of steps involved</a> in initiating video recording procedures.</p></td><td></td><td></td></tr><tr><td><p><strong>Gentle Reminders for Recording:</strong></p><p>Encourage providers to record care during handovers or other points, but avoid pressuring them.</p></td><td></td><td></td></tr><tr><td><p><strong>Voluntarily</strong></p><p>Make recording and reviewing <a href="https://github.com/LennartvdM/NFLX-nieuwe-structuur/blob/main/level-2-in-action/5.-preparation-and-consent">voluntary</a>, providers choose themselves if they want to record their interventions.</p></td><td></td><td></td></tr><tr><td><p><strong>Enrich recordings:</strong></p><p>Consider including <a href="/pages/E9MqckmSR5GGFritMwdw">respiratory data or videolaryngoscopy </a>alongside intubation footage for a more comprehensive review.</p></td><td></td><td></td></tr><tr><td><p><strong>Audio for non-technical skills:</strong></p><p>Leverage <a href="/pages/Ir50ged9KiakXjUXxlhG">audio</a> to evaluate communication, teamwork, and collaboration during procedures.</p></td><td></td><td></td></tr><tr><td><p><strong>Patient/Parent review (neonatal):</strong></p><p>Explore the possibility of showing recordings to patients or parents in neonatology for feedback and care improvement.</p></td><td></td><td></td></tr></tbody></table>

## **Developing your own protocol**

The following protocol is an example that can be used to get management permission for implementing a video review pilot program:

<details>

<summary>Sample of a video review protocol for improving care</summary>

INTRODUCTION\
Video review offers a valuable tool for reflection and improvement in emergency or intensive care settings. This protocol outlines its implementation.\
\
GOAL\
Enhance quality of care through video review as an educational tool. Improve both technical and non-technical skills during emergency interventions.\\

PREBRIEFING

* **Pre-briefing:**
  * Management informs staff (nursing & medical) about the pilot program, emphasizing a safe learning environment.
  * Gain staff buy-in through newsletters, handovers, and meetings.
* **Considerations:**
  * Importance of obtaining consent at all stages.
  * Maintaining patient privacy

PROCEDURE

1. **Before Intervention:**
   * Obtain consent from the entire team performing the intervention. (No recording if someone refuses)
   * Identify a recorder and camera position.
   * (Optional) Seek verbal consent from patient/family (when only used for quality assurance, not mandatory)
2. **Post-intervention:**
   * Standard post-briefing.
   * Re-obtain consent for video review (unused if refused)
   * Recordings stored on a secure server, accessible only to authorized personnel.
3. **Previewing by Caregivers:**
   * Obtain consent for using the video in the review session (unused if refused)

REVIEW

**Video Review Session:**

* **Focus:** Learning from successes and variations in care.
* **Duration:** Maximum 30 minutes
* **Timing:** 2-3 weeks after the procedure, during nurse handover (inviting medical staff)

POST-REVIEW

* Recordings deleted after use.
* Lessons learned inform future quality improvement initiatives.

**Medico-Legal Issues:**

* Incidents may be captured.
* Legal proceedings may require retaining evidence.
* Patient consent not mandatory for quality improvement (GDPR guidelines followed).
* All team members consented before/after recording and review. (Patient consent sought when possible).
* Legal counsel reviewed the protocol.
* Video data deleted after study completion.
* Standard practice includes video monitoring of patients in rooms.
* Recordings deemed an extension of standard care with patient consent (educational/research purposes).

**Informed Consent:**

* Not mandatory for quality improvement.
* Encouraged to obtain verbal consent from patients/families.
* Refusal to consent prevents recording.
* Triple consent process for caregivers ensures control throughout.

**Other considerations:**

* Hawthorne effect: potential for heightened performance (often positive) due to being observed.

</details>

{% embed url="<https://bmjopenquality.bmj.com/content/13/2/e002588.abstract>" %}

Action research on the department of Neonatology of the LUMC has resulted in the development of the following guideline:

<figure><img src="/files/TYVSKq1zHv1jGRE6a11R" alt=""><figcaption></figcaption></figure>


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