Using video debriefing to improve performance of the interprofessional trauma resuscitation team




Lyell, Cassie Ann


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In trauma centers, failures in teamwork account for 87.9% of preventable errors. Errors made during the primary assessment cause up to 91% of preventable deaths. Video review of trauma resuscitations has been shown to improve teamwork, communication, confidence, leadership, and timeliness of care. This quality improvement project aimed to improve trauma team performance through video analysis and a Trauma Video Debriefing Conference (TVDC). Between February and May 2021, highest-tier trauma activations were recorded and variability in (1) primary assessment completion and (2) nontechnical skills were measured. Videos demonstrating learning opportunities were shared in a TVDC. Variabilities in (1) and (2) were measured utilizing the Advanced Trauma Life Support (ATLS) Primary Assessment Completion Tool (PACT) and the Trauma Nontechnical Skills (T-NOTECHS) instruments, respectively. To assess the impact of the TVDC interventions across time, we performed a simple linear regression, with the item of interest as our outcome variable. Pre- and post-TVDC teamwork perception was measured by the TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ). To assess the provider survey items across the pre- and post- TVDC intervention, the chi-square or Fisher’s exact test was used where appropriate; the Wilcoxon Mann-Whitney U test was performed on the average module scores. During the initial project cycle, 66 trauma activations were measured, and 10 videos were reviewed across seven TVDCs, focused on team education and performance improvement. Progressive and statistically significant improvement in team performance was demonstrated, as evidenced by improved PACT (p = .0128) and T-NOTECHS (p = .0027) scores. Perception of teamwork, as measured by the T-TPQ, remained unchanged after project implementation. Implementation of a TVDC can contribute to improvement in both the technical and nontechnical performance of a TRT and is an effective tool for targeted education and quality improvement. Perception of teamwork should be studied in dependent groups in upcoming project cycles.



trauma resuscitation team, primary assessment, nontechnical skills, performance improvement, teamwork, communication



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