Observational Analysis of Video Records of Team Performance

Abstract

Observation is a traditional ethnographic approach for data collection in real dynamic workplaces. Video recording of brief, risky, but beneficial tasks was investigated for use as an enhancement of observation to assess team performance. Audio-video recording took place in a trauma center using cameras attached to the ceiling of resuscitation bays. Chest tube insertion, a task with an easily defined start and finish time, was video recorded at two levels of urgency. An expert defined task analysis was determined by interview and questionnaires and was used to identify performance problems and opportunities for task improvement. The findings were that video recording has important advantages over observation as a reusable record to extract qualitative and quantitative data. However, observation is easier, less time consuming and a less quantitable data collection tool. Particular benefits of video were the fine-grained analyses of second by second behavioral and verbal interactions and events or tasks not noted by the care providers at the time. A task analysis template was useful used to aggregate findings across multiple task accomplishments and identified task performance decrements with increased urgency. Video data contributed to identification of latent system failures and ergonomic issues that were often central to interpretation and causal hypothesis development surrounding performance problems. Video is a powerful feedback and training tool that can be used to obtain ‘buy in’ from care providers for change. Video-derived performance measures can define and be used to promote best practice performance in dynamic risky and complex medical workplaces.