{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T22:40:16Z","timestamp":1791585616516,"version":"4.3.4"},"reference-count":51,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:00:00Z","timestamp":1708473600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"University of Technology, Sydney; The NSW Biocontainment Centre, Sydney","award":["In Kind"],"award-info":[{"award-number":["In Kind"]}]},{"name":"Westmead Hospital Radiology Department, Sydney","award":["In Kind"],"award-info":[{"award-number":["In Kind"]}]},{"name":"NHMRC Centres of Research Excellence","award":["1116530"],"award-info":[{"award-number":["1116530"]}]},{"name":"NSW Biocontainment Centre","award":["In Kind"],"award-info":[{"award-number":["In Kind"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,1,23]]},"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>During a precommissioning inspection of a new biocontainment centre, radiographers noted structural features of quarantine rooms that could compromise staff and patient safety and the X-ray image quality, even after significant modifications had been made to an earlier radiography protocol. The aim of this study was to explore the safety and effectiveness of the modified protocol, in the new space, and identify improvements, if required.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study using in situ simulation and video-reflexive methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A newly built biocontainment centre, prior to its commissioning in 2021, in a large, tertiary hospital in Sydney, Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Five radiographers, and a nurse and a physician from the biocontainment centre, consented to participate. All completed the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Two simulated mobile X-ray examinations were conducted in the unit prior to its commissioning; simulations were videoed. Participants and other stakeholders analysed video footage, collaboratively, and sessions were audio recorded, transcribed and analysed thematically. Problems and potential solutions identified were collated and communicated to the hospital executive, for endorsement and actioning, if possible.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four themes were identified from the data: infection exposure risks, occupational health and exposure risks, communication and X-ray image quality. Facilitated group reviews of video footage identified several important issues, across these four areas of risk, which had not been identified previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In situ simulation is used, increasingly, to evaluate and improve healthcare practices. This study confirmed the added value of video-reflexive methods, which provided experienced participants with a richer view of a familiar protocol, in a new setting. Video footage can be examined immediately, or later if required, by a broader group of stakeholders, with diverse experience or expertise. Using video reflexivity, clinicians identified potential safety risks, which were collated and reported to the hospital executive, who agreed to implement modifications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-080152","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T01:10:20Z","timestamp":1708477820000},"page":"e080152","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Exploring the safety and quality of mobile X-ray imaging in a new infectious disease biocontainment unit: an in situ simulation and video-reflexive study"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1215-8089","authenticated-orcid":false,"given":"Mary","family":"Wyer","sequence":"first","affiliation":[{"name":"Westmead Institute for Medical Research, Westmead, New South Wales, Australia"},{"name":"K7c\u2014NSW Biocontainment Centre, Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6498-9722","authenticated-orcid":false,"given":"Su-yin","family":"Hor","sequence":"additional","affiliation":[{"name":"Faculty of Health, University of Technology Sydney, Ultimo, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8930-6414","authenticated-orcid":false,"given":"Ruth","family":"Barratt","sequence":"additional","affiliation":[{"name":"Westmead Institute for Medical Research, Westmead, New South Wales, Australia"},{"name":"Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Garrahy","sequence":"additional","affiliation":[{"name":"Radiology, Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Moore","sequence":"additional","affiliation":[{"name":"Radiology, Westmead Hospital, Westmead, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0173-3690","authenticated-orcid":false,"given":"Leah","family":"Williams Veazey","sequence":"additional","affiliation":[{"name":"Sydney Centre for Healthy Societies, School of Social and Political Sciences, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4279-3443","authenticated-orcid":false,"given":"Chris","family":"Degeling","sequence":"additional","affiliation":[{"name":"School of Health and Society, Faculty of the Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7490-6727","authenticated-orcid":false,"given":"G L","family":"Gilbert","sequence":"additional","affiliation":[{"name":"Sydney Infectious Diseases Institute, University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"2025121400463078000_14.2.e080152.1","doi-asserted-by":"crossref","DOI":"10.1097\/pq9.0000000000000189","article-title":"Prevent safety threats in new construction through integration of simulation and FMEA","volume":"4","author":"Colman","year":"2019","journal-title":"Pediatr Qual Saf"},{"key":"2025121400463078000_14.2.e080152.2","first-page":"345","article-title":"Complex projects assessment. The Impact of Built environment on healthcare staff wellbeing","volume":"12253","author":"Brambilla","year":"2020","journal-title":"Computational Science and Its Applications - Iccsa"},{"key":"2025121400463078000_14.2.e080152.3","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2014-002835"},{"key":"2025121400463078000_14.2.e080152.4","doi-asserted-by":"crossref","first-page":"726","DOI":"10.1177\/0013916518815535","article-title":"A systems framework for understanding the environment\u2019s relation to clinical teamwork: a systematic literature review of empirical studies","volume":"52","author":"Peavey","year":"2020","journal-title":"Environment and Behavior"},{"key":"2025121400463078000_14.2.e080152.5","doi-asserted-by":"crossref","unstructured":"Halamek LP . Using simulation to support evidence-based design of safer health care environments. Am J Perinatol November 11, 2022. doi:10.1055\/s-0042-1757453","DOI":"10.1055\/s-0042-1757453"},{"key":"2025121400463078000_14.2.e080152.6","doi-asserted-by":"crossref","first-page":"15","DOI":"10.3390\/ijerph18157780","article-title":"DEEP SCOPE: a framework for safe healthcare design","volume":"18","author":"Taylor","year":"2021","journal-title":"Int J Environ Res Public Health"},{"key":"2025121400463078000_14.2.e080152.7","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1108\/BEPAM-08-2020-0144","article-title":"Sources and flow of healthcare built environment design evidence","volume":"11","author":"Wanigarathna","year":"2021","journal-title":"BEPAM"},{"key":"2025121400463078000_14.2.e080152.8","unstructured":"Lamberta M , Aghera A . Latent Safety Threat Identification via Medical Simulation. Florida: StatPearls Publishing, 2022."},{"key":"2025121400463078000_14.2.e080152.9","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/PCC.0000000000003080","article-title":"Video-recorded in situ simulation before moving to the new combined neonatal\/pediatric intensive care facility: an observational study","volume":"24","author":"Krammer","year":"2023","journal-title":"Pediatr Crit Care Med"},{"key":"2025121400463078000_14.2.e080152.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12909-022-03490-9","article-title":"GENESISS 1-generating standards for in-situ simulation project: a scoping review and conceptual model","volume":"22","author":"Baxendale","year":"2022","journal-title":"BMC Med Educ"},{"key":"2025121400463078000_14.2.e080152.11","doi-asserted-by":"crossref","DOI":"10.1186\/s12909-022-03401-y","article-title":"GENESISS 2-generating standards for in-situ simulation project: a systematic mapping review","volume":"22","author":"Evans","year":"2022","journal-title":"BMC Med Educ"},{"key":"2025121400463078000_14.2.e080152.12","doi-asserted-by":"crossref","unstructured":"Arnold JL , Bosch SJ , Valipoor S . Exploring New Hospital Patient Care Spaces Using Simulation. Comprehensive Healthcare Simulation: Improving Healthcare Systems. Cham: Springer, 2021: 107\u201315.","DOI":"10.1007\/978-3-030-72973-8_15"},{"key":"2025121400463078000_14.2.e080152.13","doi-asserted-by":"crossref","first-page":"442","DOI":"10.1177\/1937586721999668","article-title":"Evaluations for new healthcare environment commissioning and operational decision making using simulation and human factors: a case study of an interventional trauma operating room","volume":"14","author":"Dub\u00e9","year":"2021","journal-title":"HERD"},{"key":"2025121400463078000_14.2.e080152.14","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e3182183c0b"},{"key":"2025121400463078000_14.2.e080152.15","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1097\/SIH.0000000000000005","article-title":"Using in situ simulation to evaluate operational readiness of a children\u2019s hospital-based obstetrics unit","volume":"9","author":"Ventre","year":"2014","journal-title":"Simul Healthc"},{"key":"2025121400463078000_14.2.e080152.16","doi-asserted-by":"publisher","DOI":"10.1097\/SIH.0b013e31820dff30"},{"key":"2025121400463078000_14.2.e080152.17","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1016\/j.ssci.2015.03.011","article-title":"Use of in-situ simulation to investigate latent safety threats prior to opening a new emergency department","volume":"77","author":"Medwid","year":"2015","journal-title":"Safety Science"},{"key":"2025121400463078000_14.2.e080152.18","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1097\/SIH.0b013e31829f7347","article-title":"In situ simulation to assess workplace attitudes and effectiveness in a new facility","volume":"8","author":"Gardner","year":"2013","journal-title":"Simul Healthc"},{"key":"2025121400463078000_14.2.e080152.19","doi-asserted-by":"publisher","DOI":"10.1197\/j.aem.2006.01.023"},{"key":"2025121400463078000_14.2.e080152.20","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/PTS.0000000000000184","article-title":"Use of simulation to test systems and prepare staff for a new hospital transition","volume":"14","author":"Adler","year":"2018","journal-title":"J Patient Saf"},{"key":"2025121400463078000_14.2.e080152.21","unstructured":"Schertzer K , Patti L . In Situ Debriefing in Medical Simulation. (Updated 2022 Sep 19) In StatPearls. Treasure Island (FL): StatPearls Publishing, 2022."},{"key":"2025121400463078000_14.2.e080152.22","doi-asserted-by":"crossref","first-page":"893","DOI":"10.2147\/AMEP.S188258","article-title":"The use of in situ simulation in healthcare education: current perspectives","volume":"11","author":"Martin","year":"2020","journal-title":"Adv Med Educ Pract"},{"key":"2025121400463078000_14.2.e080152.23","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1007\/s00112-015-3334-7","article-title":"Testlauf nach umbau der kinderintensivstation","volume":"163","author":"Keil","year":"2015","journal-title":"Monatsschr Kinderheilkd"},{"key":"2025121400463078000_14.2.e080152.24","doi-asserted-by":"crossref","unstructured":"Iedema R , Carroll K , Collier A . In: Video-Reflexive Ethnography in Health Research and Healthcare Improvement: Theory and Application. 1st edn. edn. Boca Raton, FL: CRC Press\u202f; Taylor & Francis Group: CRC Press, 2019. doi:10.1201\/9781351248013","DOI":"10.1201\/9781351248013"},{"key":"2025121400463078000_14.2.e080152.25","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1016\/j.idh.2020.01.004","article-title":"Sustained fall in inpatient MRSA prevalence after a video-reflexive ethnography project; an observational study","volume":"25","author":"Gilbert","year":"2020","journal-title":"Infection, Disease & Health"},{"key":"2025121400463078000_14.2.e080152.26","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2016-005878"},{"key":"2025121400463078000_14.2.e080152.27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjinnov-2014-000032"},{"key":"2025121400463078000_14.2.e080152.28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/1609406917690171","article-title":"Patient involvement can affect clinicians\u2019 perspectives and practices of infection prevention and control. A \u201cpost-qualitative\u201d study using video-reflexive ethnography","volume":"16","author":"Wyer","year":"2017","journal-title":"Int J Qual Methods"},{"key":"2025121400463078000_14.2.e080152.29","doi-asserted-by":"publisher","DOI":"10.1111\/jocn.12779"},{"key":"2025121400463078000_14.2.e080152.30","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1080\/13561820.2021.1874317","article-title":"A transactional approach to patient safety: understanding safe care as A collaborative accomplishment","volume":"35","author":"Pedersen","year":"2021","journal-title":"J Interprof Care"},{"key":"2025121400463078000_14.2.e080152.31","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1177\/1363459318785677","article-title":"To follow a rule? On frontline clinicians\u2019 understandings and embodiments of hospital-acquired infection prevention and control rules","volume":"24","author":"Iedema","year":"2020","journal-title":"Health (London)"},{"key":"2025121400463078000_14.2.e080152.32","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1177\/1049732318759492","article-title":"Using Positive Organizational Scholarship in Healthcare and Video Reflexive Ethnography to Examine Positive Deviance to New Public Management in Healthcare","volume":"28","author":"Dadich","year":"2018","journal-title":"Qual Health Res"},{"key":"2025121400463078000_14.2.e080152.33","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2017-007728"},{"key":"2025121400463078000_14.2.e080152.34","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1016\/j.wombi.2020.01.014","article-title":"The paradoxes of communication and collaboration in maternity care: A video-reflexivity study with professionals and parents","volume":"34","author":"Korstjens","year":"2021","journal-title":"Women Birth"},{"key":"2025121400463078000_14.2.e080152.35","doi-asserted-by":"publisher","DOI":"10.1177\/1049732307313430"},{"key":"2025121400463078000_14.2.e080152.36","doi-asserted-by":"crossref","first-page":"155","DOI":"10.5172\/mra.2011.5.2.155","article-title":"Ethnographic context meets ethnographic biography: A challenge for the mores of doing fieldwork","volume":"5","author":"Carroll","year":"2011","journal-title":"International Journal of Multiple Research Approaches"},{"key":"2025121400463078000_14.2.e080152.37","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2011-000766"},{"key":"2025121400463078000_14.2.e080152.38","doi-asserted-by":"publisher","DOI":"10.1136\/bmjqs-2022-014963"},{"key":"2025121400463078000_14.2.e080152.39","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2021-052985","article-title":"Testing the efficacy and acceptability of video-reflexive methods in personal protective equipment training for medical interns: a mixed methods study","volume":"11","author":"Wyer","year":"2021","journal-title":"BMJ Open"},{"key":"2025121400463078000_14.2.e080152.40","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1111\/medu.14156","article-title":"Using video-reflexive ethnography to understand complexity and change practice","volume":"54","author":"Ajjawi","year":"2020","journal-title":"Med Educ"},{"key":"2025121400463078000_14.2.e080152.41","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-031577","article-title":"Enriching medical trainees\u2019 learning through practice: a video reflexive ethnography study protocol","volume":"9","author":"Noble","year":"2019","journal-title":"BMJ Open"},{"key":"2025121400463078000_14.2.e080152.42","doi-asserted-by":"publisher","DOI":"10.1177\/0269216315575677"},{"key":"2025121400463078000_14.2.e080152.43","unstructured":"Hor S-Y , Wyer M , Barratt R , et al . Logistics and communication: improving the transfer of patients with high consequence infectious disease. Paper presented at: The International Australasian College for Infection Prevention and Control Conference; 2021 May 6; Online"},{"key":"2025121400463078000_14.2.e080152.44","first-page":"18","article-title":"Ebola virus disease: An imaging protocol","volume":"23","author":"Thompson","year":"2016","journal-title":"Spectrum"},{"key":"2025121400463078000_14.2.e080152.45","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s13246-020-00899-8","article-title":"Technique, radiation safety and image quality for chest X-ray imaging through glass and in mobile settings during the COVID-19 pandemic","volume":"43","author":"Brady","year":"2020","journal-title":"Phys Eng Sci Med"},{"key":"2025121400463078000_14.2.e080152.46","doi-asserted-by":"crossref","unstructured":"Terry G , Hayfield N , Clarke V , et al . Thematic analysis. In: Willig C , Stainton-Rogers W , eds. The SAGE handbook of qualitative research in psychology. 2017: 17\u201337. doi:10.4135\/9781526405555","DOI":"10.4135\/9781526405555.n2"},{"key":"2025121400463078000_14.2.e080152.47","first-page":"1","article-title":"Research as care: practice-based knowledge translation as transformative learning through video-reflexive ethnography","volume":"2023","author":"Hor","year":"2023","journal-title":"Health Sociol Rev"},{"key":"2025121400463078000_14.2.e080152.48","doi-asserted-by":"publisher","DOI":"10.5172\/mra.3.3.246"},{"key":"2025121400463078000_14.2.e080152.49","doi-asserted-by":"publisher","DOI":"10.1177\/1049732315617444"},{"key":"2025121400463078000_14.2.e080152.50","doi-asserted-by":"crossref","unstructured":"Mesman J . Boundary-spanning engagements on a neonatal ward: reflections on a collaborative entanglement between Clinicians and a researcher. In: Penders P , Vermeulen N , eds. Collaboration Across Health Research and Medical Care: Healthy Collaboration. Oxon. New York: Routledge, 2015: 171\u201394. doi:10.4324\/9781315572611","DOI":"10.4324\/9781315572611-9"},{"key":"2025121400463078000_14.2.e080152.51","unstructured":"Hor S-Y , Wyer M , Gilbert GL . Translating Video-Reflexive research methods into practitioner-led projects: challenges and opportunities. Paper presented at: ACSPRI Social Science Methodology Conference; The University of Sydney, 2018 December 12-14"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2023-080152","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T08:46:45Z","timestamp":1765702005000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2023-080152"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":51,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,2,20]]},"published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1136\/bmjopen-2023-080152"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2023-080152","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]}}}