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

2021 ◽  
Vol 3 (9) ◽  
pp. e0536
Author(s):  
Andrew K. Gold ◽  
Ann Huffenberger ◽  
Meghan Lane-Fall ◽  
Jose L. Pascual Lopez ◽  
Kristen C. Rock
Keyword(s):  
Quality Improvement ◽  
Video Review

scholarly journals Video Case Review for Quality Improvement During Cardiac Arrest Resuscitation in the Emergency Department

2021 ◽  
Author(s):  
Joseph Brooks ◽  
Ayal Pierce ◽  
Patrick McCarville ◽  
Natalie Sullivan ◽  
Anahita Rahimi-Saber ◽  
...  
Keyword(s):  
Emergency Department ◽  
Cardiac Arrest ◽  
Quality Improvement ◽  
Quality Metrics ◽  
Senior Resident ◽  
Quality Improvement Initiative ◽  
Case Review ◽  
Video Review ◽  
Review Team ◽  
Pulse Check

Background: Cardiac arrests (CA) are a leading global cause of mortality. The American Heart Association (AHA) promotes several important strategies associated with improved cardiac arrest outcomes, including decreasing pulse check time and maintaining a chest compression fraction (CCF) > 0.80. Video review is a potential tool to improve skills and analyze deficiencies in various situations, however its use in improving medical resuscitation remains poorly studied in the emergency department (ED). We implemented a quality improvement initiative, which utilized video review of cardiac arrest resuscitations in an effort to improve compliance with such AHA quality metrics. Methods: A cardiopulmonary resuscitation Video Review Team (CoVeRT) of emergency medicine residents were assembled to analyze CA resuscitations in our urban academic ED. Videos were reviewed by two residents, one of whom was a senior resident (PGY-3 or -4), and analyzed for numerous quality improvement metrics, including pulse check time, CCF, time to intravenous access, and time to patient attached to monitor. Results: We collected data on 94 cardiac arrest resuscitations between July 2017 and June 2020. Average pulse check time was 13.09 (SD ±5.97) seconds, and 38% of pulse checks were less than 10 seconds. After the implementation of the video review process, there was a significant decrease in average pulse check time (p=0.01) and a significant increase in CCF (p=0.01) throughout the study period. Conclusions: Our study suggests that the video review and feedback process was significantly associated with improvements in AHA quality metrics for resuscitation in CA among patients presented to the ED.

scholarly journals MP51-13 SURGICAL SKILL QUALITY IMPROVEMENT: UTILIZING A PEER VIDEO REVIEW WORKSHOP FOR SURGEONS PERFORMING ROBOTIC PROSTATECTOMY

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Richard Sarle ◽  
Nikola Rakic ◽  
Tae Kim ◽  
Andrew Brachulis ◽  
Brian R. Lane ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Robotic Prostatectomy ◽  
Surgical Skill ◽  
Video Review

scholarly journals Feasibility of expert and crowd-sourced review of intraoperative video for quality improvement of intracorporeal urinary diversion during robotic radical cystectomy

2017 ◽  
Vol 11 (10) ◽  
pp. 331-6 ◽  
Author(s):  
Mitchell G. Goldenberg ◽  
Jamal Nabhani ◽  
Christopher J.D. Wallis ◽  
Sameer Chopra ◽  
Andrew J. Hung ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Radical Cystectomy ◽  
Perceived Risk ◽  
High Volume ◽  
Specific Content ◽  
Logistic Regression Models ◽  
Video Review ◽  
Ileal Stricture ◽  
Robotic Radical Cystectomy ◽  
Clinically Significant

Introduction: Development of uretero-ileal stricture (UIS) after robotic-assisted radical cystectomy (RARC) may be dependent on surgical technique. Video review of intraoperative technique is an emerging paradigm for surgical quality improvement. We examined whether surgeon-perceived risk of UIS or crowd-sourced assessment of robotic skill are associated with the development of UIS.Methods: We conducted a case-control study comparing the operative technique of uretero-ileal anastomoses resulting in clinically significant UIS with the contralateral anastomosis for the same patient. De-identified videos were analyzed by 1) five high-volume surgeons; and 2) crowd workers (Crowd-Sourced Assessment of Technical Skill, C-SATS) to determine Global Evaluative Assessment of Robotic Skill (GEARS) score. Mantel-Haenszel common odds ratio (OR) estimates were calculated to assess the association between surgeon performance and the development of UIS. Logistic regression models were used to examine the association between GEARS scores and the development of UIS.Results: A total of 10 UIS videos were compared to eight control videos by five surgeons and 2142 crowd workers. Expert surgeons systematically evaluated intraoperative footage, however, no association between the expert mode response and UIS (OR 0.42; 95% confidence interval [CI] 0.05‒3.45; p=0.91) was identified. Crowd-sourced assessment was not predictive of UIS (p=0.62).Conclusions: We used video review to systematically analyze procedure-specific content and technique. The inability of surgeons to predict UIS may reflect the questionnaire, uncontrolled patient factors, or a lack of power. Crowd-sourced GEARS score was unsuccessful in predicting UIS after RARC.

Systematic Scientific Quality Improvement in Surgical Specialities. The AQS Mode

Swiss Surgery ◽  
1999 ◽  
Vol 5 (2) ◽  
pp. 62-72 ◽  
Author(s):  
Rageth ◽  
Häner ◽  
Hess ◽  
Laffer ◽  
Inderbitzi
Keyword(s):  
Quality Improvement ◽  
Scientific Quality ◽  
System 2 ◽  
Operative Eingriffe

Fragestellung: Wie lassen sich die neuen gesetzlichen Anforderungen (Statistikgesetz 1992 und Verordnungen dazu von 1993: Minimaldatensatz des Bundesamtes für Statistik [BFS] mit ICD-Codierungen sowie Krankenversicherungsgesetz 1995 mit Verordnungen dazu von 1996: Notwendigkeit der Dokumentation von Qualität und Wirtschaftlichkeit) mit sinnvollem Aufwand in den Klinikalltag integrieren? Methodik: Es wurde eine Synthese des BFS-Minimaldatensatzes mit zusätzlichen Informationen zur Qualitätssicherung in einem einzigen Fragenkatalog durchgeführt. Die Chirurgischen Kliniken des Spitals Limmattal in Schlieren und des Regionalspitals Biel haben 1995 die Arbeitsgemeinschaft für Qualitätssicherung in der Chirurgie (AQC) gegründet und das AQC-System 2 Jahre lang getestet. Resultate: Bis Ende 1997 wurden in der AQC-Statistik 15'115 operative Eingriffe dokumentiert. Der zeitliche Zusatzaufwand (zusätzlich zur obligatorischen BFS-Statistik, welche 3-10 Minuten in Anspruch nimmt) beläuft sich beim Ausfüllen der Fragebögen auf 1-3 Minuten. Diskussion: Zeitliche und finanzielle Aufwendungen steigen als Folge der gesetzlichen Anforderungen. Der Aufwand kann aber in praktikablen Grenzen gehalten werden, wenn ein einziger Fragebogen mehreren Zwecken gleichzeitig dient. So erfüllt das AQC-System nicht nur die gesetzlichen Anforderungen bezüglich systematischer Qualitätssicherung und BFS-Statistik sondern auch den Zweck der Klinik-Jahresstatistik, der individuellen operateurbezogenen Statistik und kann, wenn weitere Kliniken daran teilnehmen auch zum Vergleich der Kliniken untereinander herangezogen werden. Es fehlt noch an Standards, Referenzbereichen und Indikatoren. Diese können jedoch aufgrund des AQC-Systems nun leichter entwickelt werden, weil auf umfangreiches Zahlenmaterial abgestellt werden kann. Schlussfolgerungen: Das AQC-System hat sich im Alltag als praktikabel erwiesen und könnte als flächendeckendes System sowohl zur systematischen Qualitätssicherung als auch zur Abdeckung der übrigen Statistikbedürfnisse verwendet werden.

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