Videoreflexive method
improves postoperative handovers
Elizabeth van Rensen, MPH, PhD
Bas de Vries, RN, BSc
Center for Patient Safety
UMC Utrecht
Prof Rick Iedema, PhD
Centre for Health Communication
University of Technology
Sydney
Exercise
Introduction
WHO definition of handovers:
“The transfer of professional responsibility and accountability
for some or all aspects of care for a patient, or group of patients,
to another person or professional group on a temporary or
permanent basis”
Postoperative handovers are of special interest
– Transfer of information
– Transfer of equipment
– Unstable patients
– Time pressure
Introduction
• Patient safety is at risk during handovers
• Standard solution: a checklist
– Implementation is difficult
– Focuses on what, but not on how
• Video reflexive method:
– Engaging health care professionals creates urgency,
support and improves implementation
Exercise: reflection
5 steps of the video reflexive method
1. Engaging management and familiarising frontline staff
with the video method; exploring frontline clinicians’
concerns and needs
2. Video-recording + ‘relevance check’
3. Selecting and editing video fragments
4. Multidisciplinary feedback + improvement session(s)
5. Implementation of new handover process + evaluation
STEP 1 Engaging management and familiarising
frontline staff with the video method
• Obtain support from management
• Develop trust relationship with frontline staff
• Explain video reflexive method
• Talk about ground rules
• Discuss with frontline staff what they find worthy of
being filmed
Step 2: Video-recording + relevance check
Step 2: Video-recording + relevance check
Step 2: Video-recording + relevance check
Step 3: Selecting and editing video fragments
Do’s:
– Test the clips with someone on the team to make
sure nothing compromising is included
– Soften up your audience before you show the
footage you want to feedback
– Clips should link back to concerns expressed by
the team – new issues to be run past trusted team
member(s)
Don’t’s:
– Don’t make the clips too long (1-2 mins)
– Don’t include problem situations or ones that
might put people to shame
Step 4: Multidisciplinary feedback +
improvement session
Step 5: Implementation of new handover
process + evaluation
Discussion
Video reflexive method:
• is suitable for complex dynamic processes
• facilitates multidisciplinary learning
• gives more depth to reflection thanks to “real-life” footage
(but this can also be confronting)
• can only be used in a safe and trusted environment
• should not be used to highlight incidents
• makes implementation easier:
– process visibility -> system intervention
– professionals devise their own improvement
– creates interest in / urgency for change