Remote Video Auditing in the Surgical Setting

Surgical site infections are unintended consequences of surgery that can cause harm to patients and place financial burdens on health care organizations. Extrinsic factors in the OR-including health care providers' behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments-can increase microbial contamination. Microbes can be transported into the surgical incision by airborne or contact routes and contribute to a surgical site infection. Simple practices to prevent infection-such as minimizing airborne particles and contaminants, maintaining equipment according to the manufacturer's recommendations, cleaning and disinfecting the environment and surgical instruments, and performing proper hand hygiene-can reduce the degree of microbial contamination. Perioperative leaders and health care providers can help decrease the patient's risk of surgical site infection with proactive preventive practices that break the chain of infection.

Section: Airborne Sources and Control Of Contaminantsmentioning

confidence: 99%

Minimizing Sources of Airborne, Aerosolized, and Contact Contaminants in the OR Environment

Armellino¹

2017

“…1 It has also been used to evaluate and improve cleaning, personal protective equipment use, and endoscope reprocessing compliance. [2][3][4][5] Because of its success in these areas, some institutions have introduced the technology to improve safety, efficiency, and compliance in the OR. 2,3 Remote video auditing allows for personnel outside of the OR to view team members and activities in the OR, including preparation and performance of surgical procedures and environmental cleaning.…”

mentioning

confidence: 99%

“…[2][3][4][5] Because of its success in these areas, some institutions have introduced the technology to improve safety, efficiency, and compliance in the OR. 2,3 Remote video auditing allows for personnel outside of the OR to view team members and activities in the OR, including preparation and performance of surgical procedures and environmental cleaning. 2,6 The viewing personnel, who can be hospital staff members or third-party non-clinicians trained in recognizing and timing typical surgical activities and functions, 7 review the videos to determine if errors may be occurring.…”

mentioning

confidence: 99%

“…2,3 Remote video auditing allows for personnel outside of the OR to view team members and activities in the OR, including preparation and performance of surgical procedures and environmental cleaning. 2,6 The viewing personnel, who can be hospital staff members or third-party non-clinicians trained in recognizing and timing typical surgical activities and functions, 7 review the videos to determine if errors may be occurring. 8 Feedback to staff members can be provided in real time via status boards at a centralized location (e.g., preoperative area, corridors) or personal mobile devices.…”

mentioning

confidence: 99%

“…8 Feedback to staff members can be provided in real time via status boards at a centralized location (e.g., preoperative area, corridors) or personal mobile devices. 2,3,8 In addition, text or e-mail alerts (e.g., OR status changes, safety communication, compliance issues) can be sent to specific personnel and summary reports of performance can be generated. 3,7,9 Benefits and outcomes Use of video in the OR was first described by Hu et al 10 in 2012.…”

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confidence: 99%

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Benefits and challenges of remote video auditing in the OR

Hauk¹

2018

R emote video auditing (RVA) was initially implemented in health care as a strategy to improve hand hygiene compliance, a use that continues to be effective in recent studies. 1 It has also been used to evaluate and improve cleaning, personal protective equipment use, and endoscope reprocessing compliance. 2-5 Because of its success in these areas, some institutions have introduced the technology to improve safety, efficiency, and compliance in the OR. 2,3 Remote video auditing allows for personnel outside of the OR to view team members and activities in the OR, including preparation and performance of surgical procedures and environmental cleaning. 2,6 The viewing personnel, who can be hospital staff members or third-party non-clinicians trained in recognizing and timing typical surgical activities and functions, 7 review the videos to determine if errors may be occurring. 8 Feedback to staff members can be provided in real time via status boards at a centralized location (e.g., preoperative area, corridors) or personal mobile devices. 2,3,8 In addition, text or e-mail alerts (e.g., OR status changes, safety communication, compliance issues) can be sent to specific personnel and summary reports of performance can be generated. 3,7,9 Benefits and outcomes Use of video in the OR was first described by Hu et al 10 in 2012. Although feedback was not provided in real time, using the footage, researchers were able to identify 33 deviations in 10 surgical procedures that could be attributed to failures in communication and organizational structure. They concluded that use of video was beneficial because it helped minimize bias, aided in resolving observer discrepancies, and allowed for feedback from people who were not present at the procedure.Evidence supports the idea that by implementing RVA in the OR with real-time feedback, infection rates can decrease, patient safety can increase, and OR efficiency can improve; more specifically, it can aid in effectively applying The Joint Commission's Universal Protocol for Preventing Wrong Site, Wrong Procedure, and Wrong Person Surgery; decreasing turnover time; and improving personnel compliance with the surgical safety checklist. 2,3,7 With RVA, leaders have the option to review every procedure each day, if desired, rather than just reviewing a random sampling. 11 Video footage from the OR can also aid in training. 12 A study from 2016 indicated that RVA with realtime feedback resulted in a 14 percent reduction in turnover times and greater surgical safety checklist compliance. 7 The use of real-time notifications on OR status (e.g., "next patient in OR," "drape down") and safety information (e.g., "time out failed," "team distracted") provided personnel the opportunity to get involved, if needed, to prevent delays or address noncompliance with surgical safety checklists. 7In a 2017 study, personnel at another hospital instituted RVA with real-time feedback to address safety concerns and improve OR cleaning processes and turnover times. 2 Compliance increased from 90 to 98 ...

Remote Video Auditing to Verify OR Cleaning: A Quality Improvement Project

Armellino¹,

Dowling²,

Newman³

et al. 2018

There are many sources of contamination in the perioperative environment. Patient experience can be negatively affected by the presence of environmental contamination, especially if it is the cause of a surgical site infection. Perioperative and environmental services staff members and leaders are tasked with ensuring a clean and safe environment for their patients while maintaining an awareness of time and budgetary constraints. In addition, leaders are responsible for the competency of their staff members and must address performance issues when needed. New technological advances designed to streamline monitoring and reporting processes related to OR cleanliness are available for use. This article describes the quality improvement project that one multifacility organization completed related to the use of remote video auditing and the positive effect it had on the organization's environmental contamination.