Martin Makary, MD, MPH recently wrote an article entitled The Power of Video Recording: Taking Quality to the Next Level earlier this month for The Journal of the American Medical Association (JAMA).
Dr. Makary writes “At Indiana University, Rex et al2 decided to use the recording feature of colonoscopy video equipment to address the long-standing problem of quality variations in colonoscopies. Over several months, the investigators performed a blinded review of 98 colonoscopy videos performed by 7 gastroenterologists who were unaware that their procedures were being recorded. Procedure quality scores and mucosal inspection time data were collected based on established criteria. Wide variations in quality were found. The researchers then informed the gastroenterologists that their procedures were being video recorded and peer reviewed. Following the announcement, mean inspection time during colonoscopy increased by 49% and quality of mucosal inspection improved by 31%,2 suggesting a substantial improvement in quality because of the Hawthorne effect.”
Whether we like it or not, the increasing affordability of video-recording technology means 1984’s “Big Brother” is already here. Cameras and recording technology will eventually become so cheap that video-surveillance will be utilized in all service-based engagements. Legal issues will simply become a matter of “lets watch the tape”. To prevent malpractice suits, healthcare systems will eventually understand that an investment in training and video-recording will be the best ‘preventive maintenance’ possible against such claims. This will obviously mean system providers will be forced to ensure competency as well as adherence to policy and procedure as all future services will be recorded. Simulation, therefore, will be better understood by CFO’s to be an underlying training requirement to minimize risks, improve performance outcomes and maximize returns. Mackay says this process is already underway:
“At the Brigham and Women’s Hospital, a coaching program was developed in which surgeons spent 1 hour reviewing their procedure videos with an expert. The video-based peer review informed the surgeons about alternative approaches to problems they encountered during their operations and how they could be more efficient. The expert reviewer also suggested ways to better position the patient, surgical assistants, the surgeon, as well as the surgical retractors for optimal exposure. All of the surgeons who participated in the program found the personalized feedback to be valuable. Such video-based quality improvement intiatives could be offered remotely and even draw on the collaborative efforts among multiple institutions in a patient safety organization. Developing independent coaching networks will require an investment by hospitals, professional physician associations, and a new infrastructure, but the potential reward of improving procedure quality and safety may be substantial.”
Read the complete JAMA article today to learn more!