TRAUMA QUALITY IMPROVEMENT
Intraoperative Trauma Video Review
Published on
Apr 16, 2025
JAMA Surgery
Daniel N. Holena, MD, MSCE; Marc A. de Moya, MD, MS
Overview
The article introduces Intraoperative Trauma Video Review (IOTVR) as a novel and transformative quality improvement tool in trauma surgery. Unlike traditional methods that rely on retrospective documentation and memory, IOTVR uses audiovisual recordings of entire trauma operations to provide a real-time, objective view of both technical and nontechnical aspects of care. This innovation enables detailed feedback, targeted coaching, and the identification of systemic issues through multidisciplinary review sessions. While IOTVR holds great promise for enhancing patient safety, education, and outcomes, its broader implementation faces barriers such as cost, legal concerns, and cultural resistance. However, with increasing recognition of its value, widespread adoption is anticipated in the coming decade.
Results
The benefits of IOTVR are primarily inferred from its successful use in trauma resuscitation and elective surgery, where video review has been shown to improve protocol adherence, team communication, and training through structured, objective feedback. In the context of operative trauma care, IOTVR offers a unique opportunity to assess both technical and nontechnical skills—such as leadership, situational awareness, and teamwork—that are often undocumented in traditional medical records. By capturing real-time intraoperative events, IOTVR provides a more comprehensive and accurate basis for quality improvement and clinician development. Although direct outcome data in operative trauma is still limited, the early findings suggest that IOTVR holds significant promise for advancing clinical care, education, and patient safety.
Peer-reviewed Research
