But for experienced trauma systems and teams, routine use of the camera seemed less valuable. "You have to realize that anything [recorded on video] can get out, and then you have a significant ding on your privacy that has nothing to do with quality or whether we did a good job. It's going to be on YouTube or whatever," says Sise.
There may be a way around the privacy concern, however, if, as at Rhode Island Hospital, the video captures are not saved.
Nevertheless, Sise adds, use of a video camera is like using a blunt instrument when a sharp scalpel might be a strategically effective tool to prevent errors. "It's like using drug testing for teenage drug use. There's no substitute for good parenting," he says. Far better, he suggests, is the team's need to recognize the three highest risks for surgical errors: fatigue, familiarity, and distraction.
At Rhode Island Hospital, Cooper says that root cause analyses pointed to errors being multi-factorial with the level of surgical complexity and bilateral surgeries at the top of that list.
And, she says, since the process began there have been no wrong-site surgeries or close calls, but she emphasizes that it's not the videography that's completely responsible for the hospital's improvement.
Rather, she believes, what's different is a culture change that she and quality officials from four other hospitals and three ambulatory care centers have achieved, in collaboration with the Joint Commission's Center for Transforming Healthcare.