Streamlining neonatal Care: a success story

Neonatal Intensive Care Video Review: A Case Study from Leiden University Medical Center

The neonatal intensive care unit (NICU) at Leiden University Medical Center (LUMC) implemented video recording and review processes to enhance patient care and team performance. This case study examines the evolution and impact of these practices over more than a decade.

Background

LUMC is a tertiary university-affiliated hospital with a 25-bed NICU that admits 500-600 neonates annually. In 2009, the unit began recording neonatal stabilization procedures for research purposes. These recordings captured provider actions, infant responses, and physiological parameters.

Initial findings

Early analysis of the recordings revealed discrepancies between guideline recommendations and actual practice. Documentation was often found to be incomplete. Despite initial concerns, the recording process quickly became a routine part of care delivery.

Implementation of team reviews

In 2014, the NICU instituted weekly video review sessions, primarily attended by medical staff. These reviews complemented existing debriefing practices, allowing the team to analyze procedures in detail. This process led to improved guideline adherence and more comprehensive documentation.

Expansion of video review

From 2021, the NICU expanded its video review program to include additional procedures such as endotracheal intubation and sterile interventions. Key changes included:

1. Broadening participation to include both medical and nursing staff

2. Adding audio recording to assess team communication

3. Focusing on continuous learning and care improvement

Staff reception to the expanded program was positive, with many recognizing its value for professional development and patient care.

Long-term impact

Over two decades of video review implementation at LUMC has yielded significant insights and improvements in neonatal care. This experience informed the development of the Neoflix Toolbox, a resource designed to help other NICUs implement similar programs.

The LUMC case demonstrates the potential of systematic video review in high-stakes medical environments. By providing objective data for analysis, this approach enables ongoing refinement of clinical practices and team dynamics. As neonatal care continues to advance, video review may become an increasingly important tool for ensuring optimal patient outcomes and staff performance.