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  • Quality Improvement Article
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Record, reflect and refine: using video review as an initiative to improve neonatal care

Pediatric Research (2024)Cite this article

Abstract

Background

The goal of every medical team is to provide optimal care for their patients. We aimed to use video review (VR) sessions to identify and address areas for improvement in neonatal care.

Methods

For nine months, neonatal procedures (stabilization at birth, intubations and sterile line insertions) were video recorded and reviewed with the neonatal care providers. Action research was used to identify and address areas for improvement which were categorized as (1) protocol/equipment adjustments, (2) input for research, (3) aspects of variety, or (4) development of educational material or training programs.

Results

Eighteen VR sessions were organized with a mean(SD) of 17(5) staff members participating. In total, 120 areas for improvement were identified and addressed, of which 84/120 (70%) were categorized as aspects of variety, 20/120 (17%) as development of educational material or training programs, 10/120 (8%) as protocol/equipment adjustments, and 6/120 (5%) as input for research. The areas for improvement were grouped in themes per category, including sterility, technique, equipment, communication, teamwork, parents’ perspective and ventilation.

Conclusion

Our study showed that regularly organized VR empowered healthcare providers to identify and address a large variety of areas for improvement, contributing to continuous learning and improvement processes.

Impact

  • Video review empowered healthcare providers to identify areas for improvement in neonatal care

  • Video review gave providers the opportunity to address identified areas for improvement, either by enhancing the application of external evidence (i.e. guidelines), learning from individual clinical expertise or strengthening resilience and teamwork

  • Embedding regularly organized video review sessions allowed for continuous monitoring of care by providers, which can be beneficial for creating ongoing learning and improvement processes

  • The structured pathways, supporting implementation of changes that were proposed based on the video review sessions, could help other centers make use of the potential video review has to offer

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Fig. 1: Video review on the NICU of the LUMC.
Fig. 2
Fig. 3: Strategies for addressing the areas for improvement.
Fig. 4: Identified area for improvement requiring multiple action research cycles.

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Data availability

All data generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We acknowledge the support of the NICU team for participating in the Neoflix sessions.

Funding

A.B.teP. is a recipient of a ZonMw Safety-II grant (projectnr: 10130022010001).

Author information

Authors and Affiliations

  1. Division of Neonatology, Department of Paediatrics, Willem-Alexander Children’s Hospital, Leiden University Medical Center, Leiden, the Netherlands

    Veerle Heesters, Henriette A. van Zanten, Veerle Heijstek, Arjan B. te Pas & Ruben S.G.M. Witlox

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  1. Veerle Heesters
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  2. Henriette A. van Zanten
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  3. Veerle Heijstek
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  4. Arjan B. te Pas
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Contributions

All authors contributed to the organization of the VR sessions and the performance of action research. AtP, RW and VH designed the study. Data collection and analysis were performed by VH and RW. The first draft of the manuscript was written by VH and RW and all authors read and approved the final manuscript and agree to be accountable for all aspects of the work.

Corresponding author

Correspondence to Veerle Heesters.

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Competing interests

The authors declare no competing interests.

Consent to participate

The data of this study consists of the observations of the VR sessions and the following action research only. Additionally, verbal consent was obtained from the neonatal healthcare providers before an intervention would be recorded and used for a VR session. The recordings used for the VR sessions were part of standard care and used for quality assurance purposes only so patient consent was not sought. However, if parents were visible in a recording, they were asked for consent for use of the video in the VR session.

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Heesters, V., van Zanten, H.A., Heijstek, V. et al. Record, reflect and refine: using video review as an initiative to improve neonatal care. Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03083-w

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