Neonatology

Hospital-based Medicine

Education Pathway

Quality Improvement/Patient Safety

Emergency Medicine

Critical Care

Clinical Videorecording During Resuscitative Care: Applications for Quality Improvement, Care Optimization, and Education and Skill Maintenance

Chair(s)

• AD

  Aaron Donoghue, MD, MSCE

  Associate Professor of Critical Care Medicine and Pediatrics
  Perelman School of Medicine at the University of Pennsylvania
  CHOP
  Philadelphia, Pennsylvania, United States

Resuscitation of critically ill children presents unique challenges to both pediatric and general acute care providers. Resuscitation team members are drawn from a large pool of health care providers (HCP) with highly variable skill and experience levels. These teams are often required to perform resuscitations with limited information on underlying patient morbidity or physiologic risk factors, at any time of day or night, and with minimal advanced warning. Such fundamental procedures as cardiopulmonary resuscitation (CPR) and tracheal intubation (TI) are universally required but infrequently performed. The high acuity, low frequency nature of these events make it difficult for the individual health care provider, and by extension, the resuscitation team, to maintain clinical competency and to provide optimal resuscitation to those children who are critically ill.

The use of videorecording during clinical care has robust history in trauma resuscitation and care of the newly born infant in the delivery room. Over the past decade, a growing body of literature has demonstrated the usefulness of video review as a needs assessment, a quality improvement tool, and a data source for research in pediatric resuscitation. Video review provides clear, unbiased data on these uncommon and highly dynamic patient encounters and can yield elusive information about clinical care, teamwork, communication, and provider interactions.

In this presentation, we explore the use of clinical videorecording and several applications to assessing and improving resuscitative care. All presenting authors work in academic pediatric centers and have independently, and jointly, led efforts to improve both the care of critically ill patients in the PED and PICU and the training and education of the HCPs who provide this care. Topics covered in this presentation will include: 1) the use of video review as a novel methodology for teaching both CPR performance and ETI skills, 2) application of Crew Resource Management methods for improving resuscitation team leadership and communication, 3) development and implementation of high frequency, on-shift, in-situ simulation programs, and 4) the use of safety checklists to decrease systems variability and cognitive workload during resuscitations.

Presentations:

• 1:00 PM - 1:15 PM US CT

  Primer on Clinical Videorecording and Quality Improvement
  

  Presenter: Sage Myers, MD, MSCE – Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania
• 1:15 PM - 1:30 PM US CT

  Quantifying and Improving CPR Performance at the Individual Provider Level
  

  Presenter: Aaron Donoghue, MD, MSCE – Perelman School of Medicine at the University of Pennsylvania
• 1:30 PM - 1:45 PM US CT

  Ad Hoc Video Review and Purposeful Practice to Improve Pediatric Emergency Provider Airway Skills
  

  Presenter: Benjamin T. Kerrey, MD, MS – Cincinnati Children's Hospital Medical Center, Univeristy of Cincinnati College of Medicine
• 1:45 PM - 2:00 PM US CT

  The effects of checklist use on teamwork and workload during pediatric trauma resuscitations
  

  Presenter: Karen O'Connell, MD, MEd – Children's National Hospital
• 2:00 PM - 2:15 PM US CT

  Development and Implementation of an On-Shift, Low Cost, High Frequency Code Simulation Program in the Pediatric Emergency Department
  

  Presenter: Tara L. Neubrand, MD – University of Colorado/Children's Hospital Colorado
• 2:30 PM - 3:30 PM US CT

  Break
  

  Presenter: Belinda Thomas
• 3:30 PM - 4:00 PM US CT

  Click for Live Q&A: Clinical Videorecording During Resuscitative Care: Applications for Quality Improvement, Care Optimization, and Education and Skill Maintenance
  

  Presenter: Belinda Thomas