Trauma video review through the legal lens: Improving care while minimizing risk.

ABSTRACT: Video-based platforms have emerged as a transformative force in the field of trauma surgery. Despite its potential, the adoption of trauma video review (TVR) faces challenges. In this review, we describe the use of TVR and examine medicolegal issues pertaining to spoliation, patient privacy, and consent. Research highlights the multifaceted benefits of TVR, from refining performance metrics and medical education to improving processes of care and patient outcomes. Despite these advantages, medicolegal risks may prevent many centers from embracing this technology. Our review identified only two cases that explicitly mentioned the TVR process, where specific state statutes offered protection against video disclosure. In fact, much of the case law related to the disclosure of hospital video recording systems pertains to spoliation (destruction of evidence). Most importantly, when the creation of TVR videos is directly linked to quality assurance activities and peer review programs, Peer Review Statutes may shield these recordings from being disclosed. These statutes are thus defenses courts rely on when refusing to invoke the spoliation inference. The implementation of the Health Insurance Portability and Accountability Act act historically discouraged centers from pursuing their TVR programs due to patient privacy concerns. Nonetheless, integrating the video review consent as part of the general hospital consent can mitigate this issue. Litigation and privacy considerations still raise the alarm among providers, however, the potential for performance improvement and reduced medicolegal risk outweigh the concerns. Although TVR remains relatively underutilized, its significance will only grow as technology continues to advance.

Roll the Tape: Implementing and Harnessing the Power of Trauma Video Review.

Trauma video review (TVR) is a powerful technology with a rapidly expanding role in trauma performance improvement, education, and research. Video review is particularly well suited for evaluating elements not found in the medical record such as rapid changes in patient condition, medical decision making, resuscitation tempo, and team leadership. As such, TVR is an ideal tool for general surgery trainee education and as a means to evaluate multiple ACGME Core Competencies and entrustable professional activities. This article describes the development of a TVR program and the novel way in which we have integrated TVR into our resident trauma curriculum.

An Interprofessional, Multimodal, Family-Centered Quality Improvement Project for Sleep Safety of Hospitalized Infants.

The American Academy of Pediatrics published expanded guidelines for infant safe sleep in 2011, expanding the definition from "back to sleep" to "safe to sleep," more fully describing risk factors and guidelines. In 2016, the guidelines were revised to promote "providers modeling safe sleep behavior" to the highest level of recommendation. Previous studies have addressed the difficulty in creating clear, consistent communication between health care providers and families during an infant's inpatient stay. This institutional update describes an interprofessional and family-centered quality improvement project to improve sleep safety for hospitalized infants through a multimodal approach. Five family-centered interventions were designed: a designated safe sleep web page, a clear bedside guide to safe sleep, additional training for nursing staff in motivational interviewing, a Kamishibai card audit system, and electronic health record smart phrases. These coordinated interventions reflect advantages of an interprofessional and family-centered approach: building rapport and achieving improvements to infant sleep safety.