Optimizing Resuscitation Team Dynamics to Improve Cardiac Arrest Outcomes
|Diggs, Chelsea C.
|Problem: The American Heart Association notes that variability in resuscitation quality is common but should be considered a preventable harm as dysfunctional resuscitation team dynamics are associated with reduced survival and increased error rates. A suburban community hospital sought to improve resuscitation team dynamics to improve in-hospital cardiac arrest survival and to address frustrations with team communication, coordination, and role adherence. Purpose: The purpose of this quality improvement (QI) project was to implement and evaluate the impact of a new resuscitation team dynamic model – Team-Focused Cardiopulmonary Resuscitation (TFCPR) – on adult in-hospital cardiac arrest outcomes. Methods: This QI project was implemented over 15 weeks in Fall 2022. Staff training was implemented with a multimodal approach. Team dynamics were evaluated with the Team Emergency Assessment Measure (TEAM™) tool, which is validated for this purpose. Weekly code audits were conducted using the electronic health record. Inclusion criteria included all adult (>18 years) inpatient cardiac arrests receiving care by the Code Team. Exclusions included emergency department patients, pediatrics, and patients whose resuscitative care was not provided by the Code Team. Data collection included interval between epinephrine doses, neurologic status on arrival and discharge, initial code survival, disposition/life status at discharge, and TEAM™ tool score. Results: TEAM™ Tool completed for 2 of 12 codes (16.7%), with scores 38 – 50, indicating good to high quality performance. Survival-to-discharge rate increased from 10% pre-implementation to 16% post-implementation, with neurologic status at discharge among initial code survivors increasing from 10.5% to 40% as well as a reduction in proportion of codes with medication administration errors (57% vs. 36% post-implementation). Conclusion: TFCPR has the potential to improve resuscitation team dynamics, as reflected by staff perception of improved coordination and communication as well as a reduction in the proportion of codes with medication errors. It also has the potential to improve patient outcomes.
|Attribution-NonCommercial-NoDerivatives 4.0 International
|Patient Care Team
|Optimizing Resuscitation Team Dynamics to Improve Cardiac Arrest Outcomes