Using Trauma Video Review to Assess EMS Handoff and Trauma Team Non-Technical Skills

Nagaraj, Madhuri B.; Lowe, J.; Marinica, Alexander L.; Morshedi, Brandon; Isaacs, S. Marshal; Miller, Bruno; Chou, Andrew; Cripps, Michael W.; Dumas, Ryan P.

doi:10.1080/10903127.2021.2000684

Cited by 13 publications

(9 citation statements)

References 25 publications

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“…Three papers used the original 5point Likert scale. [20,23,25] The other two papers [21,22] utilised the same headings, but reduced the respective scales to a 3-point Likert scale. No study has been identi ed to validate this contraction.…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Video Review Tools for Assessing Non-Technical Skills in Emergency Department Resuscitation Teams: A Systematic Review

ALEXANDER,

DENNY,

GORDON

et al. 2023

Preprint

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Background and importance Use of video review in medicine is established in contexts such as surgery. Although not widely used in the emergency department (ED), some centres use it to evaluate non-technical skills (NTS) to support teaching and quality improvement. Objective There is no consensus on assessment of NTS using video review in the ED and the purpose of this review was to identify tools used in this context. Design, setting and participants Studies were identified using Embase, Medline and CINAHL. Inclusion criterion for the review was NTS of resuscitation teams working within the ED were assessed using video review. A systematic search method was used, and results were synthesised after search criteria was checked by three independent reviewers. All authors settled on the same 7 studies eligible for inclusion. Outcome measures and analysis Reliability and validity of tools identified for use in this context. Due to the heterogeneity of studies, no meta-analysis occurred. Main results There are 7 studies included in the review. The systematic review was registered with PROSPERO (Ref No: CRD42022306129). Three unique tools were identified – 5 studies used T-NOTECHS, 1 used CALM and 1 used the Communication tool. T-NOTECHS has the highest reliability score and is validated in the literature for use in this context. Conclusion T-NOTECHS is the tool of choice for assessing ED teams in this context.

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Section: Discussionmentioning

confidence: 99%

“…[20,31] In the context of measuring NTS in a trauma setting, the application of T-NOTECHS by more studies shows that authors of further studies agree with the ndings of Steinemann et al, [23] and applied the tool to their own studies. [20][21][22][23]25] The T-NOTECHS scale is shown in Fig. 2.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Video Review Tools for Assessing Non-Technical Skills in Emergency Department Resuscitation Teams: A Systematic Review

ALEXANDER,

DENNY,

GORDON

et al. 2023

Preprint

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“… 23 However, few studies have evaluated the performance of prehospital medical teams. Nagaraj et al 24 reported how higher nontechnical team skill assessments correlated with improved patient hand-off. Herzberg et al 25 demonstrated that improved prehospital teamwork skills are related to reduced rates of medical errors.…”

Section: Discussionmentioning

confidence: 99%

Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Mitchnik

Talmy

Feldman

et al. 2023

J Trauma Acute Care Surg

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BACKGROUND Trauma care teams play a crucial role in determining the outcomes of trauma victims. The composition and training of these teams can vary. Our study seeks to examine the characteristics of successful military Advanced Life Support (ALS) teams and the factors that affect them. METHODS A retrospective study was conducted at the Israel Defense Force (IDF) Military Medical Academy throughout 2021, where prehospital medical teams were observed in trauma care simulations. Teams were led by ALS providers (military physicians or paramedics) trained in IDF Military Trauma Life Support. Demographic and training data were collected. Teams were categorized into high or subpar performance groups based on simulation scores. Specific skills were assessed by trauma instructors using a points system. Scores were compared between the groups and analyzed for correlations with demographic and training data. RESULTS Overall, 63 team simulations were analyzed, with teams led by a military paramedic in 78% of simulations. The mean overall simulation performance was 81% ±6.2, and there were no differences in scores of single or multicasualty simulations. A total 3% of the teams achieved successful results and were more likely to have a paramedic as the ALS provider (p = 0.028). A sensitivity analysis excluding physicians was conducted and showed that high-performance teams had significantly higher skill assessments for primary survey (p = 0.004), injury recognition (p = 0.002), exposure (p = 0.006), adherence to clinical practice guidelines (p = 0.032), and medical device use (p = 0.002). CONCLUSION Our study found that ALS provider is associated with overall simulation performance in prehospital ALS teams, with military paramedics more likely to be successful. These findings have implications for the training and staffing of prehospital ALS teams, suggesting that teams should be composed accordingly and that training should focus on skills affected by the ALS provider type. LEVEL OF EVIDENCE Prognostic and Epidemiological; Level IV.

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“…Finally, Nagaraj et al used video review to identify modifiable behaviors during handover processes that utilized MIST. They reported that teams who adhered to using the tool scored higher when their non-technical skills were assessed in resuscitations [16], suggesting that adherence to a structured, standardized handover tool may improve team performance.…”

Section: Comparison To Other Studiesmentioning

confidence: 99%

Implementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis

et al. 2023

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Objective Patient handover between paramedics and the trauma team is vulnerable to communication errors that may adversely affect patient care. This study assesses the feasibility of a handover tool, IMIST-AMBO (acronym of categories), implementation in the trauma bay and evaluates the degree to which it improves handover metrics. Methods This is a prospective observational cohort study conducted at Canada's largest level-one trauma center. Feasibility of the tool implementation and improvement in handover metrics were assessed. Strategies for implementation included distribution of an educational video and posters, and point-of-care reminders in the trauma bay. Two reviewers independently assessed video recordings of handovers to evaluate handover metrics. Findings were compared to data obtained during a knowledge gap analysis conducted prior to the initiation of this study at the same institution. Results Over 13 weeks (August to November 2020), 140 videos were recorded, of which 80 used the IMIST-AMBO tool (compliance of 57%). Paramedic adherence to the handover structure occurred in 70.4% of cases, with greater adherence to the IMIST (82.2%) compared to the AMBO (47.1%) section. The mean (± standard deviation) handover duration was shorter (1 min:58 s ± 0:44 s during implementation vs. 2 min:47 s ± 1:14 s pre-implementation, [p < 0.001]). Frequency of parallel conversations and informal handovers improved (61% to 30% and 65% to 13%, [p < 0.001], respectively). Interruptions during the handover decreased from 3.05 (± 1.95) to 1.5 (± 1.7), p < 0.001. The tool was received favorably among study participants. ConclusionThe IMIST-AMBO tool reduced the frequency of interruptions, parallel conversations, and informal handovers during paramedic-trauma team handovers at our institution. The quality and amount of information communicated per handover improved, all with a decrease in handover duration. The IMIST-AMBO tool may be applied to other trauma centers across Canada, or more broadly on an international scale.

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Using Trauma Video Review to Assess EMS Handoff and Trauma Team Non-Technical Skills

Cited by 13 publications

References 25 publications

Evaluation of Video Review Tools for Assessing Non-Technical Skills in Emergency Department Resuscitation Teams: A Systematic Review

Evaluation of Video Review Tools for Assessing Non-Technical Skills in Emergency Department Resuscitation Teams: A Systematic Review

Exploring the characteristics of successful prehospital trauma care teams: Insights from military trauma care simulations

Implementing the IMIST-AMBO tool for paramedic to trauma team handovers: a video review analysis

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