2.3 Resources

Resources & teamwork

• Helpful Tools: Provide supporting articles, presentations, and FAQs.

• Defined Roles: Establish who manages videos, chairs reviews, etc., including a mix of disciplines for a well-rounded team.

• Provider Control: Voluntary participation and consent at multiple stages 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

Streamline Recording:

Minimize the number of steps involved in initiating video recording procedures.

Gentle Reminders for Recording:

Encourage providers to record care during handovers or other points, but avoid pressuring them.

Voluntarily

Make recording and reviewing voluntary, providers choose themselves if they want to record their interventions.

Enrich recordings:

Consider including respiratory data or videolaryngoscopy alongside intubation footage for a more comprehensive review.

Audio for non-technical skills:

Leverage audio to evaluate communication, teamwork, and collaboration during procedures.

Patient/Parent review (neonatal):

Explore the possibility of showing recordings to patients or parents in neonatology for feedback and care improvement.

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:

Sample of a video review protocol for improving care

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.

Quality improvement initiative: implementing and redefining video review of real-time neonatal procedures using action researchBMJ Open Quality

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