Remote Analysis of Team Environments (RATE)
Contents
1. re4Remote Analysis of Team Environment File Edit Tools xX O x Start Content Tone Time Case Specific Communicatio Contamination Environment Equipment Equipment Fai Foot Pedal Gas Insufflation Irrigation Lack of knowl 0 2nd Resi 2nd Resi Discussion Distraction Greeting Introduction Joking Other Cases Performance Revi Planning Problem Question Raising Concern Readback Needle Stick Other Cases x Pager y 00 00 42 Retraction of fundus cephalad 00 00 45 Cystic artery tear 00 00 46 CBD hepatic duct injury 00 00 48 Unintentional cystic duct transection 00 00 59 Excellent Teamwork 00 02 56 00 03 16 Neutral SR 44 Teaching Camera None 00 07 40 00 09 55 Neutral AA 4R Teaching None None 00 09 39 00 10 05 Neutral SA ST Request w name or role Equipment Everyone 00 42 51 00 42 55 Neutral Team SR Coaching Equipment Failure You know it 01 04 57 01 05 01 Neutral CN SS Callout Contamination None All bA User stsl End h Comments Enter Event Tra ker Edit lg ABX First Skin Incision Placement of body grapser adequate length of duct Proximal clip Division of Duct Catheter placement Secure Catheter Remove catheter Identify cystic artery Circumferential dissection Areolar tissue division Inspect liver bed End Troc2. None 00 00 02 Additional attempt at clip ligature placement on duct 00 00 07 Patient Out of Room 00 00 09 Catheter placement 00 00 33 Hola 00 00 41 Identify cystic artery 00 00 42 Retraction of fundus cephalad nd All Comments Enter User stsl Figure 6 The Scoring Screen Reload a Case into the Scoring Window To reload a previously scored case into the Scoring window 1 Select Live Case from the Toolbar 2 Select the case ID from the drop down menu that you would like to load 3 Enter a Start Time optional 4 Click Enter Summarize Conversations In the Scoring window the Conversation Scoring is located at the upper left corner as shown in Figure 7 The position will be different in Video Case video watching and Transcribe mode see Figure 17 however the interface and operation is the same This interface will allow you to mark who is talking to whom about what topic and at what time as well as annotate the conversation To record that AA anesthesia attending is teaching AR anesthesia resident 1 Click AA in the From list click AR in the To list and Teaching in the Event list respectively RATE Manual Version 8 11 04 of RATE exe 2 Click Talk or double click Teaching and a description of AA AR Teaching is shown in the right rectangle list along wi
3. 4 audio video feeds simultaneously with previously scored events e Provides all the functionality of the Live Case scoring method but with video files 3 Data Analysis e Inter Rater agreement and analysis when two different people score the same case 4 Transcribe a Case e Easy to use interface to quickly transcribe and keep track of all conversations in a video Disclaimer This software has been developed at the University of Virginia to conduct research on team performance in the hospital operating room We make no claims or guarantees as to its use We have tried to make the software somewhat customizable for other uses and therefore make the software available to you at no charge so long as it 1s used for non profit purposes Any interest in using this software for commercial for profit use should be addressed to Stephanie Guerlain at the contact information above This material is based upon work supported by the National Science Foundation under Grant No 0092985 Any opinions findings and conclusions or recommendations expressed in this material are those of the authors and do not necessarily reflect the views of the National Science Foundation RATE Manual Version 8 11 04 of RATE exe System Requirements Pentium III 1GHz recommend 256M RAM 32M video RAM 1024x768 screen resolution 1280x960 required for Video Case functionality Windows 98 SE or greater operating system Windows Media Player 9 0 Installation 1
4. Communication Matching Comparison Tracker C Counter cee RAES Shows which as have 00 29 18 4F SA lt Discussion None e 00 31 44 4F7 Team lt Performance Review None matching or similar timestamps 00 36 22 47 SA lt Reply None 00 36 36 47 SA lt Reply None between the users Configure the options for what is to be compared red 51 Percent Match 1 96 Results of the comparison User stsl f Figure 17 Analysis Window Transcribe The transcription function features a streamlined interface for watching a video and only tracking communication annotation To load start a case 1 Click the Transcribe button in the toolbar 2 Click the Open button Figure 18 3 Select a case ID from the drop down menu or enter a new case ID Figure 19 4 Select a Video Name from the drop down menu or enter a new Video Name Figure 19 Click Select to select a video file if a satisfactory one isn t already present Click Load to load the video 7 Use the interface exactly as you would for a Live Case or a Video Case on 18 RATE Manual Version 8 11 04 of RATE exe Hints 1 The 4 fast forward rewind buttons above the video can be used to skip ahead or behind 1 second or 5 seconds 2 The Playback Rate can be changed in order to slow down or speed up the video 3 A marker can be set by clicking the Checkmark button below
5. Edit the individual fields of the item as desired in the editing boxes that appear below the time list 13 RATE Manual Version 8 11 04 of RATE exe 3 Delete the item by clicking Delete or save your edits by clicking Save or cancel the operation by clicking Cancel re4Remote Analysis of Team Environment File Edit Tools x Log Out Event Tracker Start End Lists Counter From To Event Content Tone Edit Aoo M Statements ABX AA Suggestion C First Skin Incision C Placement of Fundus Grasper SR Thank me C Placement of body grapser Unknown Case Specific R ion of fumed halad Apology Communicatio etracion ee ee Self Arquing Contamination gog Retraction of body anterolateral AL Briefing C Start dissection of body infunibular junction Callout C Begin Triangle of Calot Dissection Clarifying Indentification of cystic duct oaching O Circumferential dissection of duct Annotate Time Gallbladder injury mechanical or cautery Unintentional release of the gallbaldder with grasp Gallbladder injury bile or stones spilled Liver injury without bleeding Liver injury with bleeding Major vascular injury CBD hepatic duct injury Additional attempt at clip ligature placement on du J Additional attemp at ductotomy J Additional attempt at cystic duct cannulation D Misplaced clip or ligature on cystic duct unintentional removal of cholaniogram catheter Uninten
6. End Trocar Removal 00 00 59 Excellent Teamwork illumi 00 02 56 00 03 16 Neutral SR AA Teaching Camera None v Patient Dut of Room Sand Ga 00 07 40 00 09 55 Neutral AA 4R Teaching None None SCDs i Defaut gt 00 09 39 00 10 05 Neutral SA ST Request w name or role Equipment Everyone Foley 00 42 51 00 42 55 Neutral Team SR Coaching Equipment Failure You know it C 0G NG Save As u 01 04 57 01 05 01 Neutral CN SS Callout Contamination None All X Comments Ener Save Above List As Default Save Exi User stsl Figure 12 Error Counter in Edit Mode Comments The comments field can be used for the person scoring the case to add their observations that aren t necessarily a conversation event or error These comments are entered below the time list as shown in Figure 13 Time list The time list keeps track of all communication comments events and errors that occur along with when they occur The time list can be used for instant feedback when you record an event or to edit and delete previously recorded communication comments events and errors The time list can show all items or be limited to specific items such as communication comments etc To switch between what is shown use the drop down menu as shown in Figure 13 To edit or delete an item 1 Double click on the item you would edit delete 2
7. Teaching None None 00 09 39 00 10 05 Neutral SRA ST Request w name or role Equipment Everyone 00 42 51 00 42 55 Neutral Team SR Coaching Equipment Failure You know it 01 04 57 01 05 01 Neutral CN SS Callout Contamination None z All Comments Ener E as ania O User stsl i i ai Figure 11 Event Tracker Counter To edit the errors 1 Click the Edit button at the bottom of the Counter list as shown in Figure 11 2 Enter errors and give them an associated point value using the bottom text boxes as shown in Figure 12 Delete existing errors by clicking on them and then clicking Delete Move existing errors up or down using the Up and Down buttons Click Save As Default to permanently save the changes for all future cases or Save Exit to save just for this Case ID a Rw 12 RATE Manual Version 8 11 04 of RATE exe r4Remote Analysis of Team Environment File Edit Tools Edit Counter Time 00 04 54 Content Tone Gallbladder injury mechanical or cautery ABX a 00 03 18 AA AR Teachin anes Unintentional release of the gallbaldder w aoe _ First Skin Incision Gallbladder injury bile or stones spilled C Placement of Fundus Grasper Liver injury without bleeding eats z C Placement of body grapser Liver injury with bleeding rai ie V Retraction of fundus cephalad Ma
8. will automatically be moved to the Completed Conversation list if you start a new conversation by the same person Edit Team Members and Conversation Topics All the subjects and event topics are editable by clicking the Edit button above the Event list Subjects and Events can be added or deleted as shown in Fig 8 Remote Analysis of Team Environment Oj x File Edit Tools 7 E A Eye f ke ive Case MWY PET SEY Transcribe Summary Log Out Annotate Tp 00 03 50 075 Stat Lists Counter Events Checklist J Gallbladder injury mechanical or cautery Subject Gil Events GE Cont ABX J Unintentional release of the gallbaldder with graspa Statements a ABX 1 First Skin Incision 0 Gallbladder injury bile or stones spilled Suggestion Anatomy J Liver injury without bleeding Teaching Bovie Placement of Fundus Grasper 2 Liver injury with bleeding Thank Camera Placement of body grapser 1 Major vascular injury Unknown Case Specific V Retraction of fundus cephalad CBD hepatic duct injury Apology Communicatio Ratraction of body anterolateral Additional attempt at clip ligature placement on du Arguing Contamination C Sta dissection of body infunibular junction J Additional attemp at ductotomy Briefing Environme
9. windows works the same as in the Scoring Case window Double clicking on an event will jump all the videos to that point minus several seconds to enable reviewing it H Remote Analysis of Team Environment 7 l x File Edit Tools i Live Case Wise Case bes Analysis am Transcribe 4 Summary xX Log Out Main ideo Event Tracker Secondary Video Lists Counter Events Checklist J Gallbladder injury mechanical or cautery ABX J Unintentional release of the gallbaldder with iraspg J Gallbladder injury bile or stones spilled First Skin Incision Placement of Fundus Grasper Placement of body grapser Retraction of fundus cephalad C Retraction of body anterolateral Start dissection of body infunibular junction J Liver i injury without bleeding J Liver injury with bleeding J Major vascular i injury CBD hepatic duct injury Additional attempt at clip ligat J Additional attemp at ductotom J Additional attempt at cystic d J Misplaced clip or ligature on c 0 J unintentional removal of chola Unintentional cystic duct trang J Failure to cannulate patient c J Additional atempt at clip placement on Bates J Additional attemp at cutting cystic artery J Mistaking artery for duct or duct for artery Mute other windows Play Stop Jump Mute Volume Cystic artery tear D Distracti
10. 26 04 ame Description File 1 Video 3 This video concentrates on the tools F Debriefings37044r1 mpg Clear 2 Video4 Thisis the 4th recorded video FADebriefings43035 1 mpg Clear 3 Video2 Thisis a secondary overhead video F ADebriefing327 4ri mpg L Clea 4 Main Video This is the main video of the case fADebriefing31246r1 mpg Clear EJF fm Debriefing 77444455 1 68649Lap_no_view 180023 LapDidNotRecord gaa CT 1626411 no audio mpg 1712914 audio but no video mpg 21976r1_mpg 3109014 mpg 312461r1_mpg 32714r1_mpg 37044r1_mpg 43035r1_mpg 43955rl low audio mpg 4583614 converted _mpa S f FTP Video Note Hold Ctrl for multiple selection Find and Select a Video Start User stsl Figure 14 Load Videos Together Dialog Watch Videos for a Case 1 The operation of the video watching is the same as Windows Media Player Figure 15 15 RATE Manual Version 8 11 04 of RATE exe 2 Youcan keep track of communication events and errors the same as in Live Case things are just located differently 3 You can set what information is shown in the time list by selecting from the drop down menu just like in the Live Case segment 4 You can selectively mute or enable the audio from the backup videos Figure 15 5 You can double click an event in the time list to have the videos jump to the selected time Scoring in those
11. Download the software from http www healthsystem virginia edu internet stsl Tools RATE cfm click on Tools and fill out the form completely 2 Unzip the file double click setup exe to start the installation 3 Be sure both RATE exe and RATE mdb are stored in C Program Files RATE Quick Start RATE can be started as other common software by double clicking its icon The first time you start the program you will be asked to select the database file Figure 1 The default option will be checked If you installed the program in the default place then click Save and proceed to the login screen If not then click Change find and select the database file click Save and proceed to the login screen Database Location DB Location C Program Files RATESRATE mdb Change Cancel Save Figure 1 Select Database Log In The Login Screen is shown in Figure 2 1 Click New User to bring up the new user screen 2 Enter your desired username and password 3 Log in using the username and password you have just created RATE Manual Version 8 11 04 of RATE exe Login User Name Password a Eer uit New User Select DB A Figure 2 The Login Screen User Hame Password Retype Password ail Figure 3 The New User Screen New Session After login you will be brought to a main window with a toolbar and a blank background see Figure 4 You will have 5 options to choose
12. Pasa niy B S P af User stsl A Figure 13 Time list Save and Exit a Scoring Session All data is saved as you work 1 Click the X in the top right hand corner of the window to exit the program OR 2 Click Live Case in the toolbar to go back to the Live Case setup window Figure 2 14 RATE Manual Version 8 11 04 of RATE exe Load and Review Videos for a Case 1 To load and review videos for a case choose Video Case from the toolbar after login 2 Select the case ID you would like to review from the drop down menu or type in a new case ID 3 Ifthe video names and descriptions haven t already been entered then enter a name for each video you would like to watch 4 Ifthe video files haven t already been selected then find a video file in the bottom portion of the screen and click the Select button next to the directory list The video will be automatically selected for the first available video slot see Figure 14 In order to clear a video file that has been selected click the Clear button next to the file name 5 Up to 4 video files will be loaded as shown in Figure 15 RATE will also load any previous case information for the specified case ID r4Remote Analysis of Team Environment ioj x File Edit Tools xX Log Out The Video Case Setup Video Names Dialog and Descriptions Video Case Setup case ID 02178 Clear a Selection DescriptiOQ Operating case on 6
13. RATE Manual Version 8 11 04 of RATE exe Remote Analysis of Team Environments RATE Software User s Manual Developed at the University of Virginia by Nicholas Osborne Thomas Shin Hui Guo and Stephanie Guerlain PhD Department of Systems and Information Engineering University of Virginia PO Box 400747 Charlottesville VA 22904 4747 434 924 4438 phone 434 982 2972 fax guerlain virginia edu WWW SYS virginia edu hci J Forrest Calland MD Reid Adams MD and Beth Turrentine MD PhD Surgical Technology and Safety Laboratory PO Box 801359 434 924 5836 phone calland virginia edu http hsc virginia edu stsl TOP OCT OI EA EA N ols talons gel N ea oso gel N ete onde gpa E S a tcooees ees 2 D e EEEO ENEA E EA E EE E E EA E EA EAT 2 EA CU CII E EEE EAN anc een sel N E EEE AA E TEST 3 TSU O a E E E E EE EE E 3 O D a E T ee enna eeree 3 UO OI sere ars I A O TOA A E O A A dae P A V N A N 3 NS O a E E E T E E EAA EE EEEE E E 4 E GSC LONE EE E VENE E N O O E A O E os ee de O A A OE A J O L TE G6 A E EE E ne mR E E EE E E E E 6 Reload a Case into the Scoring Window oocccccccccccccccc cece eee a aaa aaa 7 PUIG OV CUO OS a Se ees scr alte scan alse aah ws tid oc atone EEEE EEEE 7 Edit Team Members and Conversation Topics cccccccccccccccceceecc cece a a aaa a aaa aaa ae eae 9 EVO A DOR CP TASS css EA EE A EE EAEE E EE E 10 Len racier OUI CT sistis neeaaea e e Ee e Ea ra 1l COMEN E arini aea E E 13 E re E A E E E E A E E A 13
14. Save Gnd Exil a SCOVING DESSTOT sestsicccstancctwsuheds starceetsedtiocdsseateseistavecdtbtatesaiaeatecd teateteistetenet bterstataiteesstiaints 14 Toad and Review Videos Jora COSC isaiteesatotoatsxtarctesciaiorseiaiveeseltoniataadaidi e eee as 15 VGH VCO FOP COS castes E A A A A E S EA AAA encase sce se 15 OS E T E EE E A A E E AA E T E T T E 17 TON DO a e E E EEE A E EE E A E E A 18 DIB aceasta ectcce so cisco aarhene E E T A E T A E E E E E 20 Current Known Bugs Unimplemented Features UI Quirks eeeeeeeeeeeeeeeeenssrnnrsrsrrrrrrrrrrrrrrrrrrrnn 21 Om DES OTN a acct st EN EE ENO EEE NEE 21 RATE Manual Version 8 11 04 of RATE exe Introduction RATE Remote Analysis of Team Environment is a software program written in Visual Basic which provides different methods to record and score team performance All scored events and subjects can be amended quickly to fulfill different requirements The functions of RATE are as follows 1 Set Up and Score Live Cases e Setup categories and weights of scoring information e Setup video names and descriptions e Summarize conversations who is talking to whom about what for how long e Mark off predetermined checklist events e Add comments annotations e Score critical events errors positive or negative All scores and events are time stamped for later synchronization with digital video recordings of the session optional 2 Score Review and Rescore Video Cases e Watch digital files up to
15. ar Removal Placement of Fundus Grasper Retraction of fundus cephalad Retraction of body anterolateral Start dissection of body infunibular jun Begin Triangle of Calot Dissection Indentification of cystic duct Circumferential dissection of duct Distal Clip Ligature placement Sbove List As Default Save Counter Gallbladder injury mechanical or cautery Unintentional release of the gallbaldder with graspd Gallbladder injury bile or stones spilled Liver injury without bleeding Liver injury with bleeding Major vascular injury CBD hepatic duct injury Additional attempt at clip ligature placement on du Additional attemp at ductotomy Additional attempt at cystic duct cannulation Misplaced clip or ligature on cystic duct nintentional removal of cholaniogram catheter nintentional cystic duct transection ailure to cannulate patient cystic duct only mark Additional atempt at clip placement on artery Additional attemp at cutting cystic artery istaking artery for duct or duct for artery stic artery tear Aquipment failure major f quipment failue minor Edit checklist items Delete Figure 10 Event Tracker List editing Event Tracker Counter Event Tracker Counter counts the occurrences of errors with optional negative scoring Errors can be edited as required Event Tracker Counter is located on the right s
16. ations To record SR requested equipment from ST and SR answered back 1 Click SR in the From list click ST in the To list click Request w Name or Role in the Event list and click Equipment in the Content list 2 Click the Talk button or double click on Equipment and a description of SR ST Request w Name or Role Equipment is shown in the current conversation list along with the start time of that conversation 3 Click not double click SR ST Request w Name or Role Equipment in the right list to select it 4 Click Answer Back This will reverse the talkers and complete the selected conversation 5 Click Talk The text SR ST Request w Name or Role Equipment will be moved into the bottom list Another text of ST SR Reply will be added automatically to the current conversations list 6 Double click the Reply conversation in the current conversations list to end it RATE Manual Version 8 11 04 of RATE exe Hints e To list subjects can be multiple selected by clicking the subjects and holding the Ctrl key e The Tone check box can be checked which will cause a dialogue box to appear asking whether the tone was positive or negative for a given conversation e The Edit button can be selected to edit conversation topics or team members see next section e A Current Conversation
17. er J Liver injury without bleeding D Liver injury with bleeding J Major vascular injury CBD hepatic duct injury Additional attempt at clip ligature placement on du J Additional attemp at ductotomy J Additional attempt at cystic duct cannulation J Misplaced clip or ligature on cystic duct J unintentional removal of cholaniogram catheter Unintentional cystic duct transection J Failure to cannulate patient cystic duct only mark J Additional atempt at clip placement on artery J Additional attemp at cutting cystic artery J Mistaking artery for duct or duct for artery Cystic artery tear J Distractions J needle stick J contamination The Start Time was set when opening the case Long Delay Marcaine Performance Revie Planning Problem Names i Question Needle Stick Identilf cystic artery Raising Concem Other Cases Circumferential dissection Readback v Pager hd Adequate length Iak gt gt C Prowfmal Clip Distfl Clip End Division of CA and CD J delay J Equipment failure major J Equipment failue minor Argolar tissue division Ingpect liver bed Ehd Trocar Removal 00 00 00 Adequate length 00 00 00 Distal Clip Ligature placement 00 00 00 End Division of C4 and CD 00 00 01 00 00 04 Neutral ST SA Joking Equipment
18. f information Figure 20 Click Summarize Figure 20 The log will appear You can now edit this data copy it save it by clicking Save or print it by clicking Print Figure 20 20 RATE Manual Version 8 11 04 of RATE exe r4Remote Analysis of Team Environment 7 g oj x File Edit Tools anaty Statistics Detailed Descriptions check to view IV View All Events Communication Annotation Checklist Case ID 02178 Swerits Enars i pil EE User Date Scored bf 1o 20T Case Description Operating case on 6 26 04 Video Name Video 3 Select Case Description This video concentrates on the tools pie toes ii Select Amount of Info to Show Name Video 4 e Description This is the 4th recorded video Summarize Button File Location F 43035r1 mpg Name Video 2 Summary Log Description This is 4 secondary overhead video i File Location F 32714r1 mpg Print S ave Buttons Name Main Video Description This is the main video of the case File Location f 31246r1 mpg Eubanks Score Completed Tasks 4 Errors 0 Score 13 Communication Utterance Counts AR 0 AA 0 SA 0 SR 1 ST 2 SS 2 Self 0 Team 2 CN D PA 0 i Print Save User stsl 4 Figure 20 Summary Screen Current Known Bugs Unimplemented Features U Quirks we are continuously updating the program manual e Videos in wmv windows media format take a long time to scroll Video
19. fore ABX To cancel the record of ABX 1 Unclick the box before ABX 2 Confirm the cancel in the Pop up window by clicking Yes r4Remote Analysis of Team Environment File Edit Tools O x Stat f End p Lits 7 End Edt p Gallbladder injury mechanical or cautery ABS Unintentional release of the gallbaldder with graspa First Glin incasion Gallbladder injury bile or stones spilled E Placement of Fundus Grasper Liver KRY without bleeding Placement of body grapser i Retraction of fundus cephalad Retraction of body anterolateral Start dissection of body infunibular junction Begin Triangle of Calot Dissection Indentification of cystic duct Circumferential dissection of duct adequate length of duct Proximal clip Distal Clip Ligature placement Division of Duct Catheter placement Secure Catheter Remove catheter Identify cystic artery Circumferential dissection Adequate length Proximal Clip Distal Clip End Division of C4 and CD Areolar tissue division Inspect liver bed C End Trocar Removal C Skin Closed v Patient Dut of Room G Radio buttons ing artery for duct or duct for artery idjartery tear istrartions stick agnination Case Specific Communicatio Contamination Environment Equipment Equipment Fai Foot Pedal Gas lt 0 2nd Resi 2nd Resif Discussion D
20. from the toolbar e Live Case for creating or opening a case without video e Video Case for viewing scoring or re scoring a case with video e Analysis for analyzing the inter rater agreement between two users that scored the same case e Transcribe a simplified interface for transcribing the complete conversation of a video e Summary for creating and printing out a customizable log of all data collected for a case e Logout to logout of the current user and return to the login screen The user may switch back and forth between these options with ease not needing to worry about saving Because of the database structure used changes are saved instantaneously RATE Manual Version 8 11 04 of RATE exe rH Remote Analysis of Team Environment Fie Edit Tools 4 xX Log Out User stsl Figure 4 The New Session Screen Live Case Live Case enables you to score or re score a live case team session We generally score a case using this feature when watching the session live while simultaneously using other hardware software to digitally capture 4 video feeds of that session A more descriptive case description can be entered along with the standard case ID in order to make it easier to remember the case later Video names and descriptions can be associated with the case as well When you first open the case within the Video Case segment of the program you will need to provide specific video files to go alon
21. g with the video names and descriptions RATE Manual Version 8 11 04 of RATE exe H Remote Analysis of Team Environment 7 p 10 x File Edit Tools xX Log Out Live Case Setup E Case ID 0174 lt raramo ieee Enter Case ID and Description Operating case on 6 26 04 Des cription Associated Videos Name Description 1 Video 3 This video concentrates g thetee Enter Video Names and 2 video 4 This is the 4th recorded video Descriptions Optional 3 Video 2 This is a secondary overhead video 4 Main Video This is the main video of the case S et a Start Time Optional Click Start r Start Time Start Time 0 2 30 Reset Hour Min Sec Start User stsl f Figure 5 The Enter Case ID Screen To create a New Live Case 1 Select Live Case from the Toolbar Figure 4 2 Type in a case ID or click the Random Figure 5 This can be any alphanumeric you want 3 Enter a description for the case optional Enter up to 4 video names and descriptions optional 5 Ifyou enter a Start Time optional you will be able to set the time at which logging will begin This should be done if you want to synchronize your scoring session with the digital video capture of the session e g first start the digital video capture on your digital video capture computer s then set the start time on your scoring computer to be sometime after that Then once in the Scoring Screen hit Start when the di
22. gital video recording on the digitizing computer s reaches the Start Time on your scoring computer so that your scores are synchronized with the digital video s 6 Click Start You will be brought to the Live Scoring Screen Figure 6 Score a Live Case To score a case 1 Click the Start button at the upper left corner in Figure 5 which will start the timer and enable all the scoring features RATE Manual Version 8 11 04 of RATE exe 2 Score and or edit scoring features as desired how to do this is described below All scoring is saved immediately 3 Click Live Case to go back to the Live Case setup screen or click any other toolbar buttons to use their functionality f4Remote Analysis of Team Environment x File Edit Tools 1 d Live Case video Case Analysis am Transcribe y Summary xX Log Out Event Tracker End Lists Counter i Con Events Sib J Gallbladder injury mechanical or cautery ABX J Unintentional release of the gallbaldder with graspe J Gallbladder injury bile or stones spilled frion S Press Start to enable scoring First Skin Incision Placement of Fundus Grasper Placement of body grapser Retraction of fundus cephalad Retraction of body anterolateral Start dissection of body infunibular junction C Begin Triangle of Calot Dissection Indentification of cystic duct Circumferential dissection of duct Secure Catheter Remoye cathet
23. ide of the window as shown in Figure 11 As opposed to the Event Tracker Lists where an item can only be recorded once errors can be recorded multiple times To record the error of Liver injury with bleeding twice 1 Double click the event of Liver injury with bleeding twice To cancel the record of Liver injury with bleeding once 1 Double click one of the Liver injury with bleeding in the time list described below 2 Click Delete in the bottom right hand corner of the screen 11 RATE Manual r4Remote Analysis of Team Environment File Edit Tools Annotate Time 00 Content Tone Statements a 00 03 18 44 47 Teachin Suggestion Thank Unknown Case Specific Apology Communicatio Arguing Contamination Briefing Environment Callout Equipment Clarifying Equipment Fai Start C First Skin Incision _ Placement of Fundus Grasper Placement of body grapser V Retraction of fundus cephalad C Retraction of body anterolateral C Start dissection of body infunibular junctio C Begin Triangle of Calot Dissection Version 8 11 04 of RATE exe D Gallbladder injury mechanical or cautery J Unintentional release of the gallbaldder with grasp 0 Gallbladder injury bile or stones spilled J Liver injury without bleeding D Liver injury with bleeding J Major vascular injury CBD hepatic duct injury Additional attempt at clip ligat
24. if Discussion Gas Unintentional cystic duct transection Distraction Insufflation J Failure to cannulate patient cystic duct only mark Greeting Irrigation J Additional atempt at clip placement on artery Introduction Lack of knowl J Additional attemp at cutting cystic artery Joking Leaving Roorr J Mistaking artery for duct or duct for artery Other Cases Lights Cystic artery tear Performance Revie Long Delay J Distractions ning Marcaine J needle stick plem Names J contamination H of stion Needle Stick Identify cystic artery J delay sing Concem Other Cases Circumferential dissection shay gle major 1 bs fi v Adequate length J Equipment failue minor Conversations e n Mir A rai 57 aaa iane Back Distal Clip Person nd Division of CA and 00 00 46 CBD hepatic duct injury 00 00 48 Unintentional cystic duct transection 00 00 59 Excellent Teamwork 00 02 56 00 03 16 Neutral SR 44 Teaching Camera None 00 07 40 00 09 55 Neutral AA 4R Teaching None None 00 09 39 00 10 05 Neutral SA ST Request w name or role Equipment Everyone 00 42 51 00 42 55 Neutral Team SR Coaching Equipment Failure You know it Time list Holds Completed Conversations Comments and 01 04 57 01 05 01 Neutral CN SS Callout Contamination None x All Comments Enter Edit Events Cancel Delete User stsl Figure 7 Summarize Convers
25. istraction Greeting Introduction Joking Other Cases OOOO Performance Revi Planning Problem Question Raising Concern Other Cases Readback Pager v O K iment failure major igment failue minor J LJ K KO 00 00 42 Retraction of fundus cephalad 00 00 45 Cystic artery tear 00 00 46 CBD hepatic duct injury 00 00 48 Unintentional cystic duct transection 00 00 59 Excellent Teamwork 00 02 56 00 03 16 Neutral SR 44 Teaching Camera None 00 07 40 00 09 55 Neutral AA 4FR Teaching None None 00 09 39 00 10 05 Neutral SR ST Request w name or role Equipment Everyone Foley 00 42 51 00 42 55 Neutral Team SR Coaching Equipment Failure You know it J 0G NG 01 04 57 01 05 01 Neutral CN SS Callout Contamination None z SCDs All X Comments Enter a E ae User stsl Delete Figure 9 Event Tracker Lists 10 RATE Manual To edit the Event Tracker lists 1 Click the Edit button below the lists 2 The edit window will be shown as in Figure 10 3 Event Tracker list events can be added deleted and adjusted up or down in the sequence Version 8 11 04 of RATE exe 4 After editing click Save As Default to permanently save your changes or Save Exit to just save the changes for this Case ID
26. jor vascular mury Contaminalion Retraction of body anterolateral rae T duct TE j i PE T Start dissection of body infunibular junctig ie see ee Equipment _ Begin Triangle of Calot Dissection Additional ral at cystic cack cannulat Suan ee Fai L Indentification of cystic duct Misplaced clip or ligature on cystic duct G C Circumferential dissection of duct uninterigenal removal of cholaniogram cal pay eee adequate length of duct Unintentional cystic duct transection sur Proximal cli Failure to cannulate patient cystic duct o Irrigation Distal Cli rf nia clues Additional atempt at clip placement on art Lack of knowl Divisi s P Additional attemp at cutting cystic artery vision of Duct Mistaking artery for duct or duct for arter Cystic artery tear Distractions needle stick contamination delay Equipment failure major Equipment failue minor CICI Leaving Roor Lights Long Delay Marcaine Names Needle Stick K O K dentify cystic artery C Circumferential dissection V Adequate length f z Edit error types weights T Prosimal Cip e ack Distal Clip Move items up down End Division of CA and CD 00 00 45 Cystic artery tear Areolar tissue division i no Inspect liver bed 00 00 46 CBD hepatic duct injury 00 00 48 Unintentional cystic duct transection Point Yalue EIE
27. nt C Begh Triangle of Calot Dissection Additional attempt at cystic duct cannulation Callout Equipment M Indektification of cvstic duct 2 Misplaced clip or ligature on cystic duct Clarifying Equipment Fai daa Geislitaoa eae Em 0 Junintentional removal of cholaniogram catheter Coaching Foot Pedal C Circupnterential dissection of duct Unintentional cystic duct transection Discussion Gas C adeqhhate length of duct J Failure to cannulate patient cystic duct only mark Distractign sufflation Proxifhal clip J Additional atempt at clip placement on artery Greetirid Aitigation V Distal Clip Ligature placement J Additional attemp at cutting cystic artery Introduction Lack of knowl Dividion of Duct J Mistaking artery for duct for duct for artery Joking Leaving Roor v EE SPS Cystic artery tear Other Cates Lights esi dail aati bazia D Distractions Performatce Revie Long Delay L Seure Catheter J needle stick Planning Marcaine ay J contamination Problem Names VAdentify cystic artery J delay Question x Needle Stick x i gt gt hilure major hilue minor Save Exit just saves changes for this Case ID session 00 00 46 CBD Pepati n 00 00 48 Unintentional peti 00 00 59 Excellent Teamwor 00 02 56 00 03 16 Neutral 00 07 40 00 09 55 Neutral 00 09 39 00 10 05 Neutral 00 42 51 00 42 55 Neutral 01 04 57 01 05 01 Neutral All EE Edit team membe
28. ons J needle stick J contamination J delay J Equipment failure major J Equipment failue minor Catheter placement Secure Catheter Remove catheter Identify cystic artery TE ccescrsecersececeecseeseeeeerseerseesesesrersreeeers Circumferential dissection Adequate length Proximal Clip Distal Clip End Division of C4 and CD Areolar tissue division Inspect liver bed End Trocar Removal C Skin Closed Patient Dut of Room SCDs Foley 4 SJ Edit Other Cases Pager eee wos etition Y Patient History _ Iak gt gt 00 00 33 Hola Enter TETA click an an event to jump sabia hentia to that point User stsl Figure 15 Video Case Standard 16 RATE Manual Version 8 11 04 of RATE exe Case Analysis The case analysis portion of the program should be used to compare the results of two people that have scored the same case To load the database files for analysis 1 Click the Analysis button in the toolbar 2 Choose the drive in the drive and locate a database file Figure 16 3 With a database file highlighted click the Select button next to Primary DB 4 Ifyou have a second database file click the check box next to Load Secondary Database DB Highlight a second database file and click Selec
29. rs and conversation topics Save As Default saves changes permanently for future Live Cases Everyone know it ance Delete User stsl a Figure 8 Edit Team Members and Conversation Topics 1 To add personnel type the name of the person or role in the text box below the Subject column Click Enter 2 To delete a person or role select that person or role and Click the Delete button above the Subject list 3 To move a person role up or down in the list select that item then click on the Up and Down buttons RATE Manual Version 8 11 04 of RATE exe The Events and Content lists work exactly the same as the Subject list Hint e To permanently save the changes for all future cases click the Save As Default button To just save this list for this case click the Save Exit button then click Yes To exit the edit screen without saving click Save Exit button then click No Event Tracker Lists There are two event tracker lists Events and Checklist These two lists are located on the right side of the screen under the heading Lists These lists share the same space and can be easily swapped by using the radio buttons above them Checklist keeps track of overall things that happen such as Personnel Shifts Events keeps track of surgical related events that occur such as First Skin Incision To record ABX 1 Click the box be
30. s in mpg format jump around instantaneously this is a Microsoft feature not a RATE bug Comments Questions Address to Stephanie Guerlain contact info on Page 1 of this manual Send us an email if you d like to be on the distribution list for future updates 21
31. t next to Secondary DB 6 Click Load GN Remote Analysis of Team Environment E Ioj x X Log Out File Edit Tools Analyze Data J d FTP Server x Primary DB D RATE Nick Work In Progress SG mdb Select V Load Secondary Database DB Secondary DB D RATE Database BT completed RATE mdb Select User stsl a Figure 16 Analysis Setup Window To select a case and perform analysis 1 Select a case ID from the drop down menu at the top of the screen Figure 17 2 Select both User 1 and User 2 from the drop down menus at the top of the screen Figure 17 3 Select Communication Tracker or Counter radio buttons from the top right of the screen Figure 17 4 Click the Load button in the bottom left hand corner of the screen 17 RATE Manual Version 8 11 04 of RATE exe 5 You can change the Matches and Partial Matches by adding an item or removing an item from the list To add an item select the item in the drop down menu and click Add Then click the item and click either the Match or Partial Match button To remove an item click it and click the Remove button 6 Click Compare 7 The results will be displayed in the bottom right corner Select case ID users and f Remote Analysis of Team Environment l e File Edit Tools ana YSIS type i EA Live Case A Case aes Analysis am Transcribe F Summary xX og Out Comparison
32. th the start time of the conversation 3 To end the conversation double click the AA AR Teaching in the right list and the conversation end time will be marked and the text will be moved into the bottom list 15x File Edit Tools Live Case D video C m Current J4 Conversations Annotate 03 32 Start End Counter Event Content Tone Pal PS Ste 1 Gallbladder injury mechanical or cautery Statements ABX a 00 03 19 44 AR Tea i ABX J Unintentional release of the gallbaldder with graspa Suggestion Anatomy T First Skin Incision Gallbladder injury bile or stones spilled Bovie Placement of Fundus Grasper J Liver injury without bleeding Camera x si injury a ifi i ajor vascular injury rahe E Retraction of fundus cephalad CBD hepatic duct injury Arguing Contamination R traction of body anterolateral Additional attempt at clip ligature placement on du Briefing Environment Stat dissection of body infunibular junction J Additional attemp at ductotomy Callout Equipment J Additional attempt at cystic duct cannulation Clarifying Equipment Fai Misplaced clip or ligature on cystic duct Coaching Foot Pedal I unintentional removal of cholaniogram catheter J 2nd Resi 2nd Res
33. the video If at another time you click the back arrow button below the video the video will return to the marker time rRemote Analysis of Team Environment Open EER Fie Edit Tools r button SSec 1 Sec 1Sec 5Sec Playback Rate iC ipen Case Specific Communication Contamination Environment Equipment Equipment Failure Foot Pedal Gas Insufflation Irrigation Lack of knowledge Leaving Room Lights Long Delay Marcaine Names Needle Stick Other Cases Pager Patient History hone Prep Request w o name JSA Check Seeking advice Surgical Approach m Annotation Iak gt gt Answer Bach StartTime ss EmdTime Talker Responder Event Content Annotate s StartT ime EndTime Talker a onder Event Content nnatate 4 User stsl Figure 18 Transcribe Interface 19 RATE Manual Version 8 11 04 of RATE exe Case ID 02178 Descnption Operating case on 626 04 Video Mame Main Video Description This if the main video of the case File FDebrefing 31 246r1 mpa Select omen Figure 19 Open Case Screen Summary The summary section provides an interface for creating a customizable log of all data collected for a case by a user This log can then be printed or copied to another program To create a log l 2 U Select a Case Figure 20 Leave View All selected to see all information or unselect it in order to only select specific pieces o
34. tional cystic duct transection OoOOoONONNOO amp w wo Comments iscussion 1 1 i i L adequate length of duct Failure to cannulate patient cystic duct only mark istraction h U ar Patient cystic duc only mar Time list drop reeting C Proximal clip J Additional atempt at clip placement on artery troduction ack of i Distal Clip Ligature placement J Additional attemp at cutting cystic artery down menu pking Leaving f C Division of Duct Mistaking artery for duct or duct for artery ther Cases Lights Catheter placement Cystic artery tear Perflormanes nee Distractions C Secure Catheter de stick anning Marcaire R thet needle stich Problem Names L Remove catheter contamination Identify cystic artery C Circumferential dissection Adequate length C Proximal Clip Distal Clip delay Equipment failure major Equipment failue minor Question Raising Concern Readback x if ae A Cancel Delete Save era None e None buttons 00 42 51 90 42 55 Neutral Team SR Coaching Equipment Failure You know it A 01 04 57 44 05 01 Neutral CN SS Callout Contaggination None POOO S O m l lL Nitem StartTime_ EndTime Tone Talker Best Event S Content Annotate EEE p S003393 00 10 05 Neural SR TST Regus name oriole Equipment Everyone A o ONS Delete _ r i m a
35. ure placement on du J Additional attemp at ductotomy J Additional attempt at cystic duct cannulation J Misplaced clip or ligature on cystic duct Indentification of cystic duct i ra J unintentional removal of cholaniogram catheter L Circumferential dissection of duct Unintentional cystic duct transection _ adequate length of duct J Failure to cannulate patient cystic duct only mark C Proximal clip J Additional atempt at clip placement on artery WM Distal Clip Ligature placement J Additional attemp at cutting cystic artery T Division of Duct J Mistaking artery for duct or duct for artery Cystic artery tear J Distractions Coaching Foot Pedal Discussion Gas Distraction Insufflation Greeting Irrigation Introduction Lack of knowl Joking Other Cases Performance Revi Planning Problem Question Raising Concern Other Cases Readback Pager x alk V Adequate length 0 2nd Resi 2nd Resi Mj Catheter placement C Secure Catheter Remove catheter 1 Icora Identify cystic artery delay C Circumferential dissection Equipment failure major Equipment failue minor 00 00 42 Retraction of fundus cephalad Record errors 00 00 45 Cyt atey teat Edit errors 00 00 48 Unintentional cystic duct transection 00 00 59 Excellent Teamwork 0 Skin Closed 00 02 56 00 03 16 Neutral SR AA Teaching Camera None Patient Out of Room 00 07 40 00 09 55 Neutral AA 4R
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