Mackenzie C F, Xiao Y
The Charles McC Mathias Jr, National Study Centre for Trauma and EMS, University of Maryland School of Medicine, Baltimore, MD 21201, USA.
Qual Saf Health Care. 2003 Dec;12 Suppl 2(Suppl 2):ii51-7. doi: 10.1136/qhc.12.suppl_2.ii51.
Video recording is underused in improving patient safety and understanding performance shaping factors in patient care. We report our experience of using video recording techniques in a trauma centre, including how to gain cooperation of clinicians for video recording of their workplace performance, identify strengths of video compared with observation, and suggest processes for consent and maintenance of confidentiality of video records. Video records are a rich source of data for documenting clinician performance which reveal safety and systems issues not identified by observation. Emergency procedures and video records of critical events identified patient safety, clinical, quality assurance, systems failures, and ergonomic issues. Video recording is a powerful feedback and training tool and provides a reusable record of events that can be repeatedly reviewed and used as research data. It allows expanded analyses of time critical events, trauma resuscitation, anaesthesia, and surgical tasks. To overcome some of the key obstacles in deploying video recording techniques, researchers should (1) develop trust with video recorded subjects, (2) obtain clinician participation for introduction of a new protocol or line of investigation, (3) report aggregated video recorded data and use clinician reviews for feedback on covert processes and cognitive analyses, and (4) involve multidisciplinary experts in medicine and nursing.
视频记录在改善患者安全以及理解患者护理中的绩效形成因素方面未得到充分利用。我们报告了在创伤中心使用视频记录技术的经验，包括如何获得临床医生对其工作场所表现进行视频记录的合作、确定视频相对于观察的优势，以及提出视频记录的同意流程和保密措施。视频记录是记录临床医生表现的丰富数据来源，揭示了观察未发现的安全和系统问题。紧急程序和关键事件的视频记录发现了患者安全、临床、质量保证、系统故障和人体工程学问题。视频记录是一种强大的反馈和培训工具，提供了可重复使用的事件记录，可反复查看并用作研究数据。它允许对时间关键事件、创伤复苏、麻醉和手术任务进行扩展分析。为了克服部署视频记录技术中的一些关键障碍，研究人员应：（1）与视频记录对象建立信任；（2）获得临床医生对引入新方案或调查路线的参与；（3）报告汇总的视频记录数据，并利用临床医生的审查对隐蔽过程和认知分析进行反馈；（4）让医学和护理领域的多学科专家参与。
