Staff perceptions of the implementation of a trauma video review program at a level I trauma center

Abstract

Objectives: Successful implementation of any new technology requires extensive engagement with front-line staff. We explored the perceptions of emergency department and trauma staff about a trauma video review program (TVR) prior to implementation of the first such program in Canada at our level I trauma center. Methods:We conducted semi-structured individual interviews and in situ small group interviews with 35 multidisciplinary ED and trauma staff members of a teaching and research hospital in Toronto, Canada. We sought maximum variation in the sample of purposively selected participants. Interviews were recorded with audiotapes or detailed field notes, transcribed verbatim, coded, and analyzed using standard thematic analysis techniques.Results: Participants expressed overall support for the concept of TVR, but there is a core sense of unease that influenced overall staff perceptions. Despite several departmental presentations, very few participants actually had a solid understanding of how the TVR worked. Many were apprehensive about their own professional privacy, deeply concerned about vulnerable patients being filmed without consent, and questioned how video data would be used. Despite significant hesitancy, ED and trauma staff identified positive opportunities that TVR could bring, including providing an evidence base for quality improvement. Conclusions:TVR is an evolving approach to evaluate quality and patient safety in the trauma bay. As such it brings with it natural concerns and apprehension from staff regarding privacy, confidentiality, and how data will be captured and used. There is opportunity for these types of concerns to be addressed with a robust knowledge translation plan and engagement of staff throughout the implementation process.

Clinicians’ experience with technology within the physical environment of trauma rooms: a focus group study

“…The use of cameras in TRs is highly uncommon despite the benefits they could provide and staff’s positive attitude towards them (Dainty et al , 2021). It is known that the legal ramifications are one of the main barriers to video surveillance in TRs (Dumas et al , 2022).…”

Under the Lens: Team Perception of Trauma Video Review

“…In addition, the need for strong team dynamics, leadership, and quick and efficient demonstration of protocols and procedures make video review feedback incredibly effective (Davis et al, 2013; Wurster et al, 2017). Prior studies have also demonstrated that providers often feel anxiety surrounding the possibility of video review (Dainty et al, 2021; Davis et al, 2013). Our study is consistent with prior literature demonstrating the educational value of TVR; however, it expands upon concerns that providers may associate these educational sessions with anxiety and possibly even punitive intent.…”

“…Despite these benefits, there is a concern that this type of program may generate apprehension among participants (Dainty et al, 2021). Individual criticism can be seen as punitive in a group setting, and the anxiety surrounding TVR can present a barrier to implementation.…”

“…Individual criticism can be seen as punitive in a group setting, and the anxiety surrounding TVR can present a barrier to implementation. Centers with plans to start a TVR program have looked at provider perceptions prior to implementation and found that study participants saw the value in TVR but expressed anxiety about watching their performance in review (Dainty et al, 2021). Likewise, small cohort studies assessing TVR perceptions after implementation found a low to moderate risk of anxiety overall for providers already involved in these programs (Davis et al, 2013).…”