Table 8.

Issues affecting sustainability and suggested adaptations

Themes	Issue affecting sustainability	Suggested adaptations
Resources	Same day video-debriefing is resource intensive Transfer of ownership from project lead to unit leadership helps in buy-in	Conduct video-debriefing once every 2 wk on selected resuscitation recordings. Make the debriefing sessions open to all caregivers
		Provide resources for scheduling instructors, maintaining technology, and compensate for instructors time and effort Consider VR all deliveries and team members to seek video-debriefing on selected cases by attending on service/call
Low rate of VR	Hesitation to voluntarily record and participate in VR	Change from caregiver activated recording to motion sensor activated VR Link to certification/competence assessment (caregivers/learners)
System to remedy identified latent safety threats in real time	Identified but unaddressed issues result in caregiver disengagement	Set timelines for action
		Support caregivers to take ownership on addressing issues
		Communicate actions arising out of identified issues
		Establish connections with Quality and Education committees for systematic training on frequently identified issues
Inability to assess impact of team actions during resuscitation	Lack of vitals (heart rate, SpO2) data on VR	Consider superimposing vitals data on video-recording
Inconsistency in demonstrating team behaviors by caregivers	Lack of focused training in team behaviors and error prevention	Sustain video-debriefing activity for creating learning and self evaluation
	Team behavior evaluation not mandatory for maintenance of professional accreditation or trainee certification	Integrate demonstration of team behaviors during resuscitation into professional accreditation and certification requirements

VR: Video recording.