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Video recording in the emergency department: a pathway to success
  1. Adam Lloyd1,2,3,
  2. David John Lowe4,5,
  3. Simon Edgar6,7,
  4. Dave Caesar2,8,
  5. Alistair Dewar2,3,
  6. Gareth R Clegg2,3
  1. 1University of Edinburgh, Nursing Studies, Edinburgh, Scotland, UK
  2. 2Department of Emergency Medicine, NHS Lothian, Edinburgh, Scotland, UK
  3. 3University of Edinburgh, Resuscitation Research Group, Edinburgh, Scotland
  4. 4University of Glasgow, MVLS, Glasgow Royal Infirmary, Glasgow, Scotland, UK
  5. 5Emergency Department, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
  6. 6Department of Anaesthesia, NHS Lothian, Edinburgh, Scotland, UK
  7. 7University of Edinburgh, Edinburgh, Scotland, UK
  8. 8Office of the Chief Medical Officer, Scottish Government, Edinburgh, Scotland, UK
  1. Correspondence to Mr Adam Lloyd, Nursing Studies, University of Edinburgh, Doorway 6 Medical School Teviot Place Edinburgh EH8 9AG, UK; A.Lloyd{at}sms.ed.ac.uk

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At the Royal Infirmary of Edinburgh in Scotland, we video record all patients who are admitted into the ED resuscitation rooms as part of our continuous video audit system. Since installation in late 2015, numerous EDs from across the UK and abroad have repeatedly asked us the same questions: how did you do this; how did you ‘get past ethics’; how do you get consent.

The consistent problem for EDs wishing to integrate video is not the lack of supportive studies reporting video use; video-based studies have assessed the full spectrum of ED care, including communication during consultations,1 family–staff interactions2 and time-critical resuscitations.3 The problem is that there is scarce guidance on how EDs can navigate the processes that will allow them to progress with their own programme of work.4

Here, we report on our experience of the practical issues associated with video implementation, such as legality, ethics, data protection and staff acceptance, as these are the issues that are regularly cited as reasons why video is not used.5 6 By focusing on these, we can start to answer the questions above that are pertinent to all EDs that pursue video audit and move towards video becoming an essential part of care delivery.

Why video?

Video assessment has consistently shown to be a precise method of improving in clinical practice,7 8 as well as offering a level of analytical detail that is difficult to achieve with traditional observational techniques. For example, a study measuring the standard of paediatric trauma resuscitations found that compared with video assessment, routine medical record review only detected 20% of errors.9 …

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