3.2 Simple

Technical & operational policies

• Data storage and security: Approved methods for storing video data, encryption requirements, strict access controls, and data retention periods.

• Equipment standards: Specifications for recording equipment, camera placement guidelines to ensure both patient privacy and capture of relevant details.

• Video rview protocol: Structured process for video review sessions, emphasizing a safe learning environment, non-judgmental approach, and the role of a facilitator.

Consider the following questions:

Storage:

• De-identification: Are patient and provider identifiers removed to protect privacy?

• Location: Where will recordings be stored (local server, cloud-based, etc.)?

Protection:

• Encryption: Are recordings deidentified when they are stored?

• Access Control: Are access control measures implemented?(role-based permissions, audit logs)

Legal Context:

• Quality Assurance Protection: Are recordings offered protection as they are marked for quality assurance purposes?

• Case Law: Stay informed about emerging legal precedents related to the use of medical video recordings in court cases.

So far, no legal cases have been reported by any NICU. The NICU of the LUMC has implemented recording and reviewing of neonatal stabilization since 2014 and has not encountered any medicolegal issues. It is not yet clear if recordings can be used in court. (Den boer et al 2018)

Recording Equipment Selection:

• Simplicity First: Do you already have readily available technology (smartphones, tablets, basic cameras) for initial setup?

• Later Upgrades: As your program matures, consider incorporating:

  • Respiratory Monitors: If applicable, add devices to capture respiratory data alongside video.

  • Specialized Equipment: Explore high-end options for image quality, multiple angles, etc.

Click here to learn more about different approaches used by centers who have successfully implemented video review.

Important Considerations:

• Security and privacy: Systems must align with hospital data security and patient privacy regulations (e.g., HIPAA compliant).

• Storage and access: Integration with secure storage and controlled access protocols is a must.

• Ease of use: Equipment should be intuitive for staff to operate to minimize disruptions to workflow.

• Cost and scalability: Consider the initial investment, as well as any ongoing costs associated with storage and maintenance.

Clear rules regarding storage, de-identification, location, protection, and quality assurance of recordings promote trust and reduce provider anxiety. This transparency fosters participation and protects the integrity of the video review process. By establishing a structured and ethical approach, you maximize the program's potential for safety improvement and avoid potential challenges.

Without clear rules, your video review program risks losing credibility. Providers might feel uneasy about how their recordings are handled, leading to distrust and reluctance to participate. The lack of transparency could generate concerns about privacy, misuse of videos, and potential legal complications. This could undermine the learning process and hinder the program's ability to positively impact safety.