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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.
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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