Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands
Department of Paediatrics, Leiden University Medical Center, Leiden, The Netherlands.
BMJ Open Qual. 2024 May 15;13(2):e002588. doi: 10.1136/bmjoq-2023-002588.
Video review (VR) of procedures in the medical environment can be used to drive quality improvement. However, first it has to be implemented in a safe and effective way. Our primary objective was to (re)define a guideline for implementing interprofessional VR in a neonatal intensive care unit (NICU). Our secondary objective was to determine the rate of acceptance by providers attending VR. For 9 months, VR sessions were evaluated with a study group, consisting of different stakeholders. A questionnaire was embedded at the end of each session to obtain feedback from providers on the session and on the safe learning environment. In consensus meetings, success factors and preconditions were identified and divided into different factors that influenced the rate of adoption of VR. The number of providers who recorded procedures and attended VR sessions was determined. A total of 18 VR sessions could be organised, with an equal distribution of medical and nursing staff. After the 9-month period, 101/125 (81%) of all providers working on the NICU attended at least 1 session and 80/125 (64%) of all providers recorded their performance of a procedure at least 1 time. In total, 179/297 (61%) providers completed the questionnaire. Almost all providers (99%) reported to have a positive opinion about the review sessions. Preconditions and success factors related to implementation were identified and addressed, including improving the pathway for obtaining consent, preparation of VR, defining the role of the chair during the session and building a safe learning environment. Different strategies were developed to ensure findings from sessions were used for quality improvement. VR was successfully implemented on our NICU and we redefined our guideline with various preconditions and success factors. The adjusted guideline can be helpful for implementation of VR in emergency care settings.
视频回顾（VR）在医疗环境中的程序可用于促进质量改进。然而，首先必须以安全有效的方式实施。我们的主要目标是（重新）定义在新生儿重症监护病房（NICU）中实施跨专业 VR 的指南。我们的次要目标是确定参加 VR 的提供者的接受率。在 9 个月的时间里，使用研究小组评估了 VR 课程，研究小组由不同的利益相关者组成。在每次会议结束时嵌入一份问卷，以获取提供者对会议和安全学习环境的反馈。在共识会议上，确定了成功因素和前提条件，并将其分为影响 VR 采用率的不同因素。确定了记录程序和参加 VR 课程的提供者人数。共组织了 18 次 VR 课程，医疗和护理人员的分布均匀。9 个月后，在 NICU 工作的所有 125 名提供者中的 101/125（81%）至少参加了 1 次会议，125 名提供者中的 80/125（64%）至少记录了 1 次程序的执行情况。共有 179/297（61%）的提供者完成了问卷。几乎所有的提供者（99%）都报告对审查会议有积极的意见。确定并解决了与实施相关的前提条件和成功因素，包括改进获得同意的途径、准备 VR、定义会议期间主席的角色以及建立安全的学习环境。制定了不同的策略来确保从会议中获得的发现用于质量改进。我们在 NICU 成功实施了 VR，并针对各种前提条件和成功因素重新定义了我们的指南。经调整的指南有助于在急救环境中实施 VR。
