Background: Timely and accurate chest tube placement in the Emergency Department (ED) is critical for the management of life-threatening conditions such as a pneumothorax. At Medical City North Hills Emergency Department, chest tube placement can be delayed or complicated due to variability in available equipment types, sizes, storage locations, and setup processes. Providers may be unfamiliar with less commonly used kits, experience skill decay due to infrequent procedural exposure, or lack access to bedside educational resources during high-stress, time-sensitive situations. These challenges contribute to procedural delays, increased complication rates, prolonged hospital stays, and higher healthcare costs. This quality improvement project aims to address these issues through the development and implementation of standardized, easily accessible instructional videos to improve procedural efficiency, provider confidence, and patient safety.
Methods: This initiative was conducted at Medical City North Hills Emergency Department and included emergency physicians, residents, advanced practice providers, nurses, respiratory therapists, and supply chain staff involved in chest tube placement. Short, standardized “how-to” videos were developed demonstrating appropriate chest tube and pigtail catheter selection, equipment setup, and insertion technique. Videos were made accessible via QR codes placed near chest tube kits and workstations, allowing providers to review content immediately prior to procedures. System-focused interventions included workflow modifications to support consistent kit retrieval and setup, while clinician-focused interventions targeted procedural education and refresher training. Complication rates associated with ED chest tube placements were tracked through manual chart review in Meditech during patient admission. Video utilization and provider feedback to be monitored to support iterative improvement.
Results: Implementation of standardized instructional videos improved provider familiarity with available equipment and reduced uncertainty during setup and insertion. Providers reported increased confidence in chest tube selection and placement, contributing to more efficient procedural workflows. Early tracking demonstrated a reduction in procedural delays and chest tube–related complications, including malposition, dislodgement, and the need for repeat attempts. Improved standardization also enhanced team communication and reduced time spent searching for supplies, supporting more reliable and consistent patient care.
Conclusion: The introduction of concise, standardized, QR code–accessible instructional videos effectively addressed key root causes of delayed and complicated chest tube placement in the ED. By improving provider confidence, streamlining equipment setup, and promoting consistent technique, this initiative enhanced patient safety, reduced complications, and supported high-quality emergency care.