Filming for auditing of real-life emergency teams: a systematic review

Brogaard, Lise; Uldbjerg, Niels

doi:10.1136/bmjoq-2018-000588

Cited by 16 publications

(26 citation statements)

References 93 publications

(382 reference statements)

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“…However, this is not a proof of causality. This study and prior studies demonstrated that video can capture teams' behavior, timing of procedures, and the flow of an algorithm and can be reviewed repeatedly (8). This information can be difficult for the healthcare providers to recall after the management of an emergency, and studies have found written documentation in the patient files may be misleading when compared to videos (25,26).…”

Section: Discussionmentioning

confidence: 83%

“…Little is known about the importance of non-technical skills and interdisciplinary teamwork of resuscitation teams. Video recording such teams (2) to review their performance enables in-depth analysis of non-technical and clinical team performance (1,(8)(9)(10). Prediction of a problematic transition and the need for resuscitation may be difficult and as a result, first line personnel including midwives and obstetricians may need to provide resuscitative interventions in the first minutes after birth.…”

Section: Introductionmentioning

confidence: 99%

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Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

et al. 2022

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BackgroundLittle is known about the importance of non-technical skills for the adherence to guidelines, when teams of midwives, obstetricians, anesthesiologists, and pediatricians resuscitate and support the transition of newborns. Non-technical skills are competences underpinning successful teamwork in healthcare. These are usually referred to as leadership, situational awareness, communication, teamwork, decision making, and coping with stress and fatigue.ObjectiveBy review of videos of teams managing newborns with difficult transition, we aimed to investigate whether the level of the teams' non-technical skills was associated with the degree of adherence to guidelines for newborn resuscitation and transitional support at birth.MethodsFour expert raters independently assessed 43 real-life videos of teams managing newborns with transitional difficulties, two assessed the non-technical score and two assessed the clinical performance. Exposure was the non-technical score, obtained by the Global Assessment Of Team Performance checklist (GAOTP). GAOTP was rated on a Likert Scale 1–5 (1 = poor, 3 = average and 5 = excellent). The outcome was the clinical performance score of the team assessed according to adherence of the European Resuscitation Counsel (ERC) guideline for neonatal resuscitation and transitional support. The ERC guideline was adapted into the checklist TeamOBS-Newborn to facilitate a structured and simple performance assessment (low score 0–60, average 60–84, high 85–100). Interrater agreement was analyzed by intraclass correlation (ICC), Bland-Altman analysis, and Cohen's kappa weighted. The risk of high and low clinical performance was analyzed on the logit scale to meet the assumptions of normality and constant standard deviation.ResultsTeams with an excellent non-technical score had a relative risk 5.5 [95% confidence interval (CI) 2.4–22.5] of high clinical performance score compared to teams with average non-technical score. In addition, we found a dose response like association. The specific non-technical skills associated with the highest degree of adherence to guidelines were leadership and teamwork, coping with stress and fatigue, and communication with parents. Inter-rater agreement was high; raters assessing non-technical skills had an interclass coefficient (ICC) 0.88 (95% CI 0.79–0.94); the neonatologists assessing clinical performance had an ICC of 0.81 (95% CI 0.66–0.89).ConclusionTeams with an excellent non-technical score had five times the chance of high clinical performance compared to teams with average non-technical skills. High performance teams were characterized by good leadership and teamwork, coping with stress, and fatigue and communication with parents.

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Section: Discussionmentioning

confidence: 83%

Section: Introductionmentioning

confidence: 99%

Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

et al. 2022

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“…A more direct approach would involve auditing the direct performance of the emergency team, such as by live recordings. This is, however, rarely described and not easily used 51 …”

Section: Discussionmentioning

confidence: 99%

The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis

Brogaard

Lauridsen

Løfgren

et al. 2021

Acta Obstet Gynecol Scand

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Introduction Little is known about the optimal simulation‐based team training in obstetric emergencies. We aimed to review how simulation‐based team training affects patient outcomes in obstetric emergencies. Material and methods Search Strategy: MEDLINE, Embase, Cochrane Library, and Cochrane Central Register of Controlled Trials were searched up to and including May 15, 2021. Selection criteria: randomized controlled trials (RCTs) and cohort studies on obstetric teams in high‐resource settings comparing the effect of simulation‐based obstetric emergency team training with no training on the risk of Apgar scores less than 7 at 5 min, neonatal hypoxic ischemic encephalopathy, severe postpartum hemorrhage, blood transfusion of four or more units, and delay of emergency cesarean section by more than 30 min. Data collection and analysis: The included studies were assessed using PRISMA, EPCO, and GRADE. Results We found 21 studies, four RCTs and 17 cohort studies, evaluating patient outcomes after obstetric team training compared with no training. Annual obstetric emergency team training may reduce brachial plexus injury (six cohort studies: odds ratio [OR] 0.47, 95% CI 0.33–0.68; one RCT: OR 1.30, 95 CI% 0.39–4.33, low certainty evidence) and suggest a positive effect; but it was not significant on Apgar score below 7 at 5 min (three cohort studies: OR 0.77, 95% CI 0.51–1.19; two RCT: OR 0.87, 95% CI 0.72–1.05, moderate certainty evidence). The effect was unclear for hypoxic ischemic encephalopathy, umbilical prolapse, decision to birth interval in emergency cesarean section, and for severe postpartum hemorrhage. Studies with in situ multi‐professional simulation‐based training demonstrated the best effect. Conclusions Emerging evidence suggests an effect of obstetric team training on obstetric outcomes, but conflicting results call for controlled trials targeted to identify the optimal methodology for effective team training.

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“…Furthermore, video analysis can be a powerful adjunct to existing QI methodologies for understanding the context and the events leading to an adverse event ( 4 ). In particular, video review allows for analysis of nontechnical aspects of managing critical situations such as teamwork, closed-loop communication, leader performance, adherence to role responsibilities, and situational awareness ( 1 , 4 , 7 , 10 ). These critical components of management of emergency situations in the ICU have been captured, reviewed, and discussed in our video review program.…”

Section: Discussionmentioning

confidence: 99%

Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education

Gold

Huffenberger

Lane‐Fall

et al. 2021

Critical Care Explorations

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Objectives: The objectives of this study were to codify the events triggering bedside recording and to report the types of performance issues identified that were then used to inform dedicated ICU quality improvement efforts. Design: This is a retrospective descriptive analysis of a video review program conducted at a single institution from July 2016 to November 2019. Setting: Surgical and Trauma ICU at a single urban academic quaternary care center. Patients: All patients admitted to the surgical and trauma ICU between July 2016 and November 2019 were eligible for the study as all ICU beds in our health system institutions are equipped with closed circuit video/audio monitoring. Through an institutional review board approved program, any event triggering the immediate bedside presence of a provider in the ICU is routinely recorded at the discretion of the care team or tele-intensivist. Interventions: A database of these events was created over a 3-year period, and cases were reviewed for content, quality improvement, and educational opportunities. Select recordings were analyzed and shared at multidisciplinary/multiprofessional video review sessions. Measurements and Main Results: There were 286 critical events video recorded and reviewed in the ICUs between July 2016 and November 2019. The most commonly recorded events included: cardiopulmonary arrests ( n = 75), intubations ( n = 71), and acute clinical decompensation triggered by nonreassuring vital signs ( n = 57) or arrhythmias ( n = 13). Of these recordings, 59 were shared at video review conferences, where quality of care was assessed and thematic opportunities for improvement were characterized. Recurrent quality improvement themes that were identified included adherence to protocols, the importance of teamwork and closed-loop communication, clearly designated team leadership, and the use of universal precautions. Conclusions: Video review in the ICU is feasible and presents valuable opportunities for quality improvement and educational discussions.

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Filming for auditing of real-life emergency teams: a systematic review

Cited by 16 publications

References 93 publications

Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

Teamwork and Adherence to Guideline on Newborn Resuscitation—Video Review of Neonatal Interdisciplinary Teams

The effects of obstetric emergency team training on patient outcome: A systematic review and meta‐analysis

Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education

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