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Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education

The objectives of this study were to codify the events triggering bedside recording and to report the types of performance issues identified that were then used to inform dedicated ICU quality improvement efforts. DESIGN: This is a retrospective descriptive analysis of a video review program conduct...

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Autores principales: Gold, Andrew K., Huffenberger, Ann, Lane-Fall, Meghan, Pascual Lopez, Jose L., Rock, Kristen C.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437213/
https://www.ncbi.nlm.nih.gov/pubmed/34589714
http://dx.doi.org/10.1097/CCE.0000000000000536
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author Gold, Andrew K.
Huffenberger, Ann
Lane-Fall, Meghan
Pascual Lopez, Jose L.
Rock, Kristen C.
author_facet Gold, Andrew K.
Huffenberger, Ann
Lane-Fall, Meghan
Pascual Lopez, Jose L.
Rock, Kristen C.
author_sort Gold, Andrew K.
collection PubMed
description The objectives of this study were to codify the events triggering bedside recording and to report the types of performance issues identified that were then used to inform dedicated ICU quality improvement efforts. DESIGN: This is a retrospective descriptive analysis of a video review program conducted at a single institution from July 2016 to November 2019. SETTING: Surgical and Trauma ICU at a single urban academic quaternary care center. PATIENTS: All patients admitted to the surgical and trauma ICU between July 2016 and November 2019 were eligible for the study as all ICU beds in our health system institutions are equipped with closed circuit video/audio monitoring. Through an institutional review board approved program, any event triggering the immediate bedside presence of a provider in the ICU is routinely recorded at the discretion of the care team or tele-intensivist. INTERVENTIONS: A database of these events was created over a 3-year period, and cases were reviewed for content, quality improvement, and educational opportunities. Select recordings were analyzed and shared at multidisciplinary/multiprofessional video review sessions. MEASUREMENTS AND MAIN RESULTS: There were 286 critical events video recorded and reviewed in the ICUs between July 2016 and November 2019. The most commonly recorded events included: cardiopulmonary arrests (n = 75), intubations (n = 71), and acute clinical decompensation triggered by nonreassuring vital signs (n = 57) or arrhythmias (n = 13). Of these recordings, 59 were shared at video review conferences, where quality of care was assessed and thematic opportunities for improvement were characterized. Recurrent quality improvement themes that were identified included adherence to protocols, the importance of teamwork and closed-loop communication, clearly designated team leadership, and the use of universal precautions. CONCLUSIONS: Video review in the ICU is feasible and presents valuable opportunities for quality improvement and educational discussions.
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spelling pubmed-84372132021-09-28 Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education Gold, Andrew K. Huffenberger, Ann Lane-Fall, Meghan Pascual Lopez, Jose L. Rock, Kristen C. Crit Care Explor Quality Improvement Report The objectives of this study were to codify the events triggering bedside recording and to report the types of performance issues identified that were then used to inform dedicated ICU quality improvement efforts. DESIGN: This is a retrospective descriptive analysis of a video review program conducted at a single institution from July 2016 to November 2019. SETTING: Surgical and Trauma ICU at a single urban academic quaternary care center. PATIENTS: All patients admitted to the surgical and trauma ICU between July 2016 and November 2019 were eligible for the study as all ICU beds in our health system institutions are equipped with closed circuit video/audio monitoring. Through an institutional review board approved program, any event triggering the immediate bedside presence of a provider in the ICU is routinely recorded at the discretion of the care team or tele-intensivist. INTERVENTIONS: A database of these events was created over a 3-year period, and cases were reviewed for content, quality improvement, and educational opportunities. Select recordings were analyzed and shared at multidisciplinary/multiprofessional video review sessions. MEASUREMENTS AND MAIN RESULTS: There were 286 critical events video recorded and reviewed in the ICUs between July 2016 and November 2019. The most commonly recorded events included: cardiopulmonary arrests (n = 75), intubations (n = 71), and acute clinical decompensation triggered by nonreassuring vital signs (n = 57) or arrhythmias (n = 13). Of these recordings, 59 were shared at video review conferences, where quality of care was assessed and thematic opportunities for improvement were characterized. Recurrent quality improvement themes that were identified included adherence to protocols, the importance of teamwork and closed-loop communication, clearly designated team leadership, and the use of universal precautions. CONCLUSIONS: Video review in the ICU is feasible and presents valuable opportunities for quality improvement and educational discussions. Lippincott Williams & Wilkins 2021-09-10 /pmc/articles/PMC8437213/ /pubmed/34589714 http://dx.doi.org/10.1097/CCE.0000000000000536 Text en Copyright © 2021 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (https://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Quality Improvement Report
Gold, Andrew K.
Huffenberger, Ann
Lane-Fall, Meghan
Pascual Lopez, Jose L.
Rock, Kristen C.
Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title_full Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title_fullStr Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title_full_unstemmed Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title_short Leveraging Telemedicine for Quality Improvement Video Review of Critical ICU Events: A Novel Multidisciplinary Form of Education
title_sort leveraging telemedicine for quality improvement video review of critical icu events: a novel multidisciplinary form of education
topic Quality Improvement Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8437213/
https://www.ncbi.nlm.nih.gov/pubmed/34589714
http://dx.doi.org/10.1097/CCE.0000000000000536
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