Pushing boundaries of video review in trauma: using comprehensive data to improve the safety of trauma care

Abstract

Adverse events and lapses in safety are identified after the fact and often discussed through postevent review. These rounds rely on personal recollection, information from patient charts and incident reports that are limited by retrospective data collection. This results in recall bias and inaccurate or insufficient detail related to timeline, incidence and nature adverse events. To better understand the interplay of the complex team and task-based challenges in the trauma bay, we have developed a synchronized data capture and analysis platform called the Trauma Black Box (Surgical Safety Technologies, Toronto). This system continuously acquires audiovisual, patient physiological and environmental data from a sophisticated array of wall-mounted cameras, microphones and sensors. Expert analysts and software-based algorithms then populate a data timeline of case events from start to finish, retaining a handful of anonymized video clippings to supplement the review. These data also provide a consistent and reliable method to track specific quality metrics, such as time to trauma team assembly or time to blood product arrival. Furthermore, data can also be linked to patients’ electronic medical records to explore relationships between initial trauma resuscitation and downstream patient-oriented outcomes. A video capture and data analysis system for the trauma bay overcomes the inherent deficiencies in the current standard for evaluating patient care in the trauma bay and offers exciting potential to enhance patient safety through a comprehensive data collection system.

Defining adverse events during trauma resuscitation: a modified RAND Delphi study

“…This taxonomy of AEs provides the framework for a standardized analysis of both intrafacility and interfacility trauma resuscitations. Additionally, this taxonomy can serve as the foundation for targeted QI and patient safety initiatives including video review 12–16. By integrating this taxonomy into an institutional trauma video review program, reproducible and reliable analyses can occur.…”

“…Additionally, this taxonomy can serve as the foundation for targeted QI and patient safety initiatives including video review. [12][13][14][15][16] By integrating this taxonomy into an institutional trauma video review program, reproducible and reliable analyses can occur. A common language and understanding of AEs applied during the video review process may allow for more accurate comparisons of trauma resuscitations and a more comprehensive understanding of the sequence of events leading to the AE.…”

Errors in adult trauma resuscitation: a systematic review

“…Adaptation of an agreed upon classification system for errors would allow for improved homogeneity of reporting in future studies and comparison between different centers [10]. A classification system could also be used for assessment of resuscitation by video review or machinelearning assisted algorithms to enhance patient safety in the trauma bay [30].…”

Contemporary uses of trauma video review: a scoping review

“…Trauma video review can also provide a reliable method to track specific quality metrics, such as whether the trauma team was assembled prior to patient arrival or time to blood product administration. Some trauma video review programs also allow any team member to flag a resuscitation for review anonymously, allowing all team members to have a voice and promoting a culture of safety in trauma [30].…”