Building the Business Case for Surgical Video Review: Beyond ROI to Measurable Value

Surgical video review programs deliver significant educational and quality benefits to surgical providers and perioperative staff, but traditional return on investment calculations often fail to capture their true value. Rather than forcing strict financial metrics, successful institutions build comprehensive business cases that demonstrate measurable improvements aligned with strategic priorities. This approach acknowledges that transformative healthcare investments including patient safety, education, and quality improvement often transcend simple cost-benefit analyses while still providing substantial clinical and organizational value. The key to securing support lies in focusing on specific, quantifiable outcomes your institution already tracks—or should consider tracking—such as training efficiency gains, enhanced case review thoroughness, and measurable quality improvements. Academic medical centers may particularly want to begin systematically tracking these outcomes to demonstrate value and build compelling cases for future investments. 

The Challenge of Quantifying Value 

Surgical video review¹ programs face a fundamental challenge: while their educational and quality benefits are well-documented, translating these outcomes into traditional return on investment (ROI) calculations remains elusive. Unlike equipment purchases or quality improvement initiatives with direct cost-benefit ratios, surgical video review programs generate value across multiple domains—education, quality, safety, and culture—and are not as easily quantifiable. Successful video review programs should focus on building comprehensive business cases that demonstrate measurable value and are well aligned with key institutional priorities.  

Framework for Building Your Business Case 

The foundation of any successful video review program begins with understanding how it aligns with your institution's existing strategic priorities. Academic medical centers typically focus on resident training efficiency,² competency milestones,³ research productivity,⁴ and faculty development.⁵ Community hospitals prioritize quality metrics, patient safety scores,⁶ physician recruitment,⁷ and competitive differentiation.⁸ Health systems seek standardization across facilities,⁹ knowledge transfer between sites, and scalable training programs¹⁰ that enhance their brand reputation. 

This alignment matters because it transforms video review from an additional expense into a strategic investment that supports goals already embedded in your institution's mission and budget. Surgical video review technology becomes easier to justify when it directly supports existing initiatives or future projects along the institution’s strategic roadmap.  

Quantifying Specific, Measurable Outcomes 

Successful programs focus on specific metrics their institutions already track, rather than broad ROI claims. Training efficiency improvements become evident through reduced time to competency milestones.¹¹ Quality and safety indicators show measurable improvement through improved surgical technique performance,¹² reduced complication rates,¹³ enhanced protocol compliance,¹⁴ and more efficient case review processes for quality improvement initiatives.¹⁵  

Operational benefits emerge through streamlined case review processes¹⁶ and reduced time spent on incident investigations,¹⁷ and in the future, enhanced documentation¹⁸ that supports accreditation and regulatory compliance while decreasing staff burden and manual work. These tangible outcomes provide concrete evidence of program value without requiring complex financial calculations that may not accurately capture the full scope of benefits. 

Evidence-Based Value Propositions 

Surgical research¹⁹ demonstrates concrete surgical training²⁰ benefits that translate to institutional value and clinical impact. Studies show that the integration of video review into training curricula increases knowledge retention and reduces time to achieve technical proficiency.²¹ Programs with robust video review practices report better case preparation and higher resident participation²² in surgical cases.  

Quality improvement initiatives are vital to learning health systems and become evident through enhanced peer review processes.²³ Automated video analytics also helps identify system-level issues that individual case reviews miss,²⁴ enabling preventive interventions that address variations in surgical technique and non-technical skills such as team communication before they result in complications.  

Risk mitigation efforts, while difficult to quantify precisely, provide substantial value through complete procedural records that support better risk assessment²⁵ to mitigate future legal challenges. Proactive quality management through earlier identification of concerning patterns prevents escalation to adverse events, and video review is increasingly being used in healthcare systems that strive for high reliability and improved patient safety practices.¹⁵ 

Building Your Proposal 

A compelling proposal begins with a clear problem statement that identifies specific challenges your program will address. This foundation supports measurable objectives that define 3-5 specific, quantifiable goals aligned with institutional priorities. Success metrics must be concrete and achievable, with clear indicators of program effectiveness tied to outcomes your institution already values. A realistic timeline with specific milestones provides accountability and demonstrates systematic progress toward program goals. 

Consider establishing year-one goals such as achieving 90% faculty participation in monthly video review sessions, reducing average case discussion time by 25% while improving thoroughness scores, and documenting 3-5 specific quality improvements identified through the analysis of surgery videos.²⁶ Longer-term expansion goals might include demonstrable improvement in resident training milestone achievement, establishing video review as standard practice for high-risk procedures, and developing institutional expertise for broader health system implementation. 

Conclusion: Value Beyond Numbers 

Successful surgical video review programs don't justify themselves through traditional ROI metrics—they demonstrate value through measurable improvements in education, quality, and patient safety with strategic alignment with institutional priorities. By focusing on specific, quantifiable outcomes and building comprehensive business cases, surgical leaders can secure support for programs that transform how we teach, learn, and improve surgical care. 

The key is not to oversell financial returns that may be difficult to measure, but to build compelling cases for investments that deliver substantial value in ways that matter most to your institution and, ultimately, to the patients you serve. Video review programs that align with strategic priorities, demonstrate measurable outcomes, and follow thoughtful implementation plans, become essential tools for institutional success rather than short-term educational enhancements. 

Recommended Reading

1. Villarreal, J. (2024, November 4). Surgical Video Review: A Gold Mine for New Residents and Fellows [blog]. Surgical Safety Technologies. https://www.surgicalsafety.com/blog/surgical-video-review-gold-mine-for-new-residents-fellows

2. Tanaka, R., DeAsis, F., Vigneswaran, Y., et., al. (2018). Video review program enhances resident training in laparoscopic inguinal hernia: a randomized blinded controlled trial. Surg Endosc.;32(6), 2847–51. https://doi.org/10.1007/s00464-017-5992-0

3. Kumins, N.H., Qin, V.L., Driscoll, E.C., et., al. (2021).  Computer-based video training is effective in teaching basic surgical skills to novices without faculty involvement using a self-directed, sequential and incremental program. The American Journal of Surgery;221(4), 780–7. https://doi.org/10.1016/j.amjsurg.2020.08.011

4. Eckhoff, J.A., Rosman, G., Altieri, M.S., et., al. (2023). SAGES consensus recommendations on surgical video data use, structure, and exploration (for research in artificial intelligence, clinical quality improvement, and surgical education). Surg Endosc.;37(11), 8690-8707. https://doi.org/10.1007/s00464-023-10288-3  

5. Larkins, K., Mansour, K., Costello, D., et., al. (2023). Recommendations for the design of video-based educational interventions as instructional tools in robotic surgical training. J Robot Surg.;17(3), 779–84. https://link.springer.com/article/10.1007/s11701-022-01513-7

6. Creating Safety Systems in Health Care Organizations. (2000). In Kohn, L.T., Corrigan, J.M., & Donaldson, M.S. (Eds), To Err is Human: Building a Safer Health System. National Academies Press. https://www.ncbi.nlm.nih.gov/books/NBK225188/

7. Association for Advancing Physician and Provider Recruitment. (n.d.) Using Technological Innovation to Attract and Retain Future Physicians [blog]. https://aappr.org/2024/08/28/using-technological-innovation-to-attract-and-retain-future-physicians/

8. Mohamad, T.A., Bastone, A., Bernhard, F., & Schiavone, F. (2023). How artificial intelligence impacts the competitive position of healthcare organizations. Journal of Organizational Change Management;(36)8, 49-79. https://doi.org/10.1108/JOCM-03-2023-0057

9. Revolutionizing Healthcare: The Role of Healthcare Technology Management. (2024, February 13). TechNation. https://1technation.com/revolutionizing-healthcare-the-role-of-healthcare-technology-management/

10. Callahan, M.E., Brant, E.B., Mohan, D., et., al. (2021). Leveraging Technology to Overcome the "Scalability Problem" in Communication Skills Training Courses. ATS Sch.;2(3), 327-340. https://doi.org/10.34197/ats-scholar.2020-0164PS

11. Daniel, R., McKechnie, T., Kruse, C.C., et., al. (2023). Video-based coaching for surgical residents: a systematic review and meta-analysis. Surg Endosc.;37(2), 1429–39. https://doi.org/10.1007/s00464-022-09379-4

12. Jopling, J.K., & Visser, B.C. (2021). Mastering the thousand tiny details: routine use of video to optimize performance in sport and in surgery. ANZ Journal of Surgery;91(10), 1981–6. https://doi.org/10.1111/ans.17076

13. Pangal, D.J., Kugener, G., Cardinal, T., et., al. (2022). Use of surgical video–based automated performance metrics to predict blood loss and success of simulated vascular injury control in neurosurgery: a pilot study. Journal of Neurosurgery;137(3), 840-849. https://doi.org/10.3171/2021.10.JNS211064

14. Surgical Safety Technologies. (2024, June 17). WHO Surgical Safety Checklist: Research-Backed Efficacy, Real-World Neglect [blog]. https://www.surgicalsafety.com/blog/who-surgical-safety-checklist

15. Dumas, R.P. (2025, February 5). How video review enhances surgical care, education and performance improvement [blog]. Baylor College of Medicine. https://blogs.bcm.edu/2025/02/05/how-video-review-enhances-surgical-care-education-and-performance-improvement/

16. van de Graaf, F.W., Lange, M.M., Spakman, J.I., et., al. (2019). Comparison of Systematic Video Documentation With Narrative Operative Report in Colorectal Cancer Surgery. JAMA Surg.;154(5), 381-389. https://www.doi.org/10.1001/jamasurg.2018.5246

17. Rees, J.R., Maher, Z., Dumas, R.P., et., al. (2022). Trauma video review outperforms prospective real-time data collection for study of resuscitative thoracotomy. Surgery;172(5), 1563-1568. https://www.surgicalsafety.com/clinical-research/trauma-video-review-resuscitative-thoracotomy

18. Surgical Safety Technologies. (2025, June 18). SST Unveils Breakthrough AI-Powered Case Summaries: Transforming Clinical Documentation Through Ambient Intelligence [press release]. https://www.surgicalsafety.com/company/news/sst-unveils-ai-powered-case-summaries 

19. Villarreal, J. (2025, February 26). Enhance Surgical Research Using the Black Box Platform™ [blog]. Surgical Safety Technologies. https://www.surgicalsafety.com/blog/enhance-surgical-research-using-black-box-platform 

20. Villarreal, J. (2025, April 16). Redefining Surgical Training: Harnessing Technology for Resident Growth [blog]. Surgical Safety Technologies. https://www.surgicalsafety.com/blog/redefining-surgical-training-for-resident-growth

21. Ahmet, A., Gamze, K., Rustem, M,. & Sezen, K.A. (2018). Is Video-Based Education an Effective Method in Surgical Education? A Systematic Review. Journal of Surgical Education;75(5), 1150-1158. https://doi.org/10.1016/j.jsurg.2018.01.014

22. Kim, M.P., Del Calvo, H., Chihara, R., & Chan, E.Y. (2022). Video-based curriculum improves resident participation during robot-assisted surgery. J Thorac Dis.;14(12), 4641-4649. https://www.doi.org/10.21037/jtd-22-603

23. Ibrahim, A.M., Varban, O.A., & Dimick, J.B. (2016). Novel Uses of Video to Accelerate the Surgical Learning Curve. J Laparoendosc Adv Surg Tech A.;26(4):240-2. https://doi.org/10.1089/lap.2016.0100

24. Nazir, A., Shore. E.M., Keown-Stoneman, C., et., al. (2024). Enhancing patient safety in trauma: Understanding adverse events, assessment tools, and the role of trauma video review. The American Journal of Surgery;234, 74-79. https://www.surgicalsafety.com/clinical-research/enhancing-patient-safety-in-trauma 

25. Surgical Safety Technologies. (2025, January 14).  MedPro Group Endorses Surgical Safety Technologies’ OR Black Box® as Ground-breaking Technology to Improve Surgical Quality and Safety [press release]. https://www.surgicalsafety.com/company/news/medpro-group-endorses-surgical-safety-technologies-or-black-box-as-ground-breaking-technology-to-improve-surgical-quality-and-safety

26. Villarreal, J. (2025, January 9). Surgery Videos: Preparing Residents and Fellows for OR Autonomy [blog]. Surgical Safety Technologies. https://www.surgicalsafety.com/blog/surgery-videos-transforming-training