Video capture of clinical care to enhance patient safety

Abstract

Experience from other domains suggests that videotaping and analyzing actual clinical care can provide valuable insights for enhancing patient safety through improvements in the process of care. Methods are described for the videotaping and analysis of clinical care using a high quality portable multi-angle digital video system that enables simultaneous capture of vital signs and time code synchronization of all data streams. An observer can conduct clinician performance assessment (such as workload measurements or behavioral task analysis) either in real time (during videotaping) or while viewing previously recorded videotapes. Supplemental data are synchronized with the video record and stored electronically in a hierarchical database. The video records are transferred to DVD, resulting in a small, cheap, and accessible archive. A number of technical and logistical issues are discussed, including consent of patients and clinicians, maintaining subject privacy and confidentiality, and data security. Using anesthesiology as a test environment, over 270 clinical cases (872 hours) have been successfully videotaped and processed using the system.

A quantitative study of disruption in the operating room during laparoscopic antireflux surgery

“…Most importantly, video data can be analyzed repeatedly and by multiple observers, which increases the validity and reliability of the findings [8,9]. The video-aided field study has a unique role for conducting quantitative studies on OR efficiency, error prevention, and surgical education [8][9][10][11][12][13].…”

Ergonomic task analysis of ultrasound-guided femoral nerve block: a pilot study

“…Heights and distances were measured using a measuring tape. Angles were estimated by direct observation and assessment of photographs [15]. Success of the block was assessed by comparing verbal rating pain scores (VRS) on passive movements immediately before and 10 minutes after the procedure.…”

Validation of use of wireless monitors to measure levels of mobility during hospitalization

“…As technology has improved, a variety of potential methods has become available, including global positioning systems (GPSs) [14][15], video recording [16], and small wireless accelerometers [17][18]. Unfortunately, the patient may consider video too intrusive, especially during hospitalization, and a GPS records where a person is in the environment not the level of mobility that is occurring.…”