Communication, education essential for increased cardiac arrest survival at hospitals
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Hospitals with successful resuscitation teams for in-hospital cardiac arrest were more likely to have increased rates of survival compared with other hospitals, according to a study published in Circulation.
Brahmajee K. Nallamothu, MD, MPH, professor in the division of cardiovascular diseases and director of the Michigan Integrated Center for Health Analytics and Medical Prediction at University of Michigan, and colleagues analyzed data from nine hospitals from the Get With the Guidelines-Resuscitation registry from 2012 to 2014. Information gathered during in-depth interviews of administrative and clinical staff was used to calculate risk-standardized rates of survival to discharge for each hospital each year, in addition to identify top-performing, middle-performing and bottom-performing hospitals.
Within the nine hospitals included in the story, 158 individuals were interviewed, including nurses (45.6%), administration (20.3%), physicians (17.1%) other clinical staff (17.1%).
The interviews helped researchers identify four broad themes that were related to resuscitation teams for in-hospital cardiac arrest in top-performing hospitals compared with the other hospitals: team composition and roles, team design, training and education, and communication and leadership.
The following features were commonly seen in top-performing hospitals: designated or dedicated resuscitation teams, participation by team members of diverse disciplines during in-hospital cardiac arrest, clearly defined responsibilities and roles for all team members, improved leadership and communication and in-depth mock codes.
“Our findings highlight the importance of dedicated or designated resuscitation teams at hospitals,” Nallamothu and colleagues wrote. “Top-performing hospitals described dedicated teams as a powerful way of achieving the consistent clinical expertise and teamwork required for effectively managing these high-stakes events. However, dedicated teams are not likely to be feasible at many hospitals, as they can require resource investments that may be barriers for some facilities.”
In a related editorial, Elizabeth H. Bradley, PhD, president of Vassar College, wrote: “The recommendations Nallamothu and colleagues make are in principle achievable by hospitals more broadly, particularly supported by evidence of interventions that can shift organizational culture in ways to improve outcome. This suggests that concerted efforts nationally might in fact result in tens of thousands of lives saved annually.” – by Darlene Dobkowski
Disclosures: The authors and Bradley report no relevant financial disclosures.