Video Debriefing at the Delivery Ward
Video Debriefing at the Delivery Ward
Postpartum hemorrhage continues to be the leading cause of maternal morbidity and mortality
 worldwide. Successful management of postpartum hemorrhage requires not only administration of
 the right medicine, but also a rapid and coordinated response from a multi-professional team.
 A prerequisite for this is that the individuals are well trained, which the investigators
 believe can be improved by video debriefing of real-life events.

 The purpose of this study is to improve obstetric teams management of postpartum hemorrhage
 using video recordings of real-life events in post event debriefings.

 Cameras are placed in the ceiling of all delivery rooms to record obstetric teams' management
 of postpartum hemorrhage. Video recording requires informed consent from all participants.
 After an event, the team will review their own performance on video in a debriefing session
 to improve future performance.
Background:

 Video review was first introduced in healthcare in the 1980s to improve emergency teams'
 management of critical situations by having them review their own performance on video in a
 debriefing session. Video debriefing offers an opportunity to review the care delivered in
 high-stake, high-risk, and time-critical situations. Video debriefing has been found to
 improve the performance of neonatal resuscitation teams and trauma teams; however, video
 debriefing has not generally been accepted in the delivery ward. A recent PhD project
 developed a method for systematically filming obstetric emergencies, in two Danish hospitals,
 where informed consent had been obtained from all participants. In addition, the project
 developed a method for systematically assessing obstetric teams' clinical performance during
 postpartum hemorrhage

 The aim of the study is to examine the effect of real-life video debriefing on obstetric
 teams' management of major postpartum hemorrhage.

 Material and methods:

 The study will be conducted at two Danish hospitals, Aarhus University Hospital (5,000
 deliveries per year) and Horsens Regional Hospital (2,300 deliveries per year).

 All delivery rooms have been equipped with an automatic recording system that enables filming
 of all postpartum hemorrhage. Video recording requires informed consent from all
 participants. Women expecting to deliver will be invited to provide informed consent for
 video recording. If a woman declines the invitation, the cameras will be covered up according
 to our protocol. If video recording occurs, all participants will be asked to give informed
 consent again.

 Video debriefing will be conducted by educated facilitators of debriefing. Debriefings will
 follow a protocol and will focus on teams' clinical performance and non-technical skills. The
 main focus of the debriefing protocol will be clinical debriefing with a main goal of
 improving clinical performance and patient care.

 Videos will be included as follows: 1) Baseline video inclusion, before introducing real-life
 video debriefings of team performance; 2) During the start-up of the debriefings in an
 exploratory study; 3) After real-life video debriefings have been introduced as standard
 procedure.

 Perspectives:

 This project is the first to evaluate the implementation, feasibility and use of real-life
 video debriefing in obstetric care. Results from this project can revolutionize the ability
 to learn from clinical cases and can guide how video can be introduced in ways acceptable to
 women, relatives and healthcare providers.
Inclusion Criteria:

 -  Women with major postpartum hemorrhage (1.0 liter or more).

 Exclusion Criteria:

 -  Language difficulties requiring an interpreter or translator