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Tools, Teams, and Training: Revisioning Critical Components of Resuscitation Care

August 9, 2022
August 9, 2022

This blog is taken from a recent HealthStream webinar – Tools, Teams and Training: Revisioning Critical Components of Resuscitation Care. The webinar was moderated by HealthStream’s Luther Cale, Vice President, Clinical Programs and featured Brian Ross, MD, PhD, Co-Founder and Chief Medical Officer, Format Health and Michelle Howe, RN, Clinical Operations Director, Format Health.

Performance during a cardiac emergency has historically been difficult to manage, problematic to accurately document and even harder to prepare for. Disappointingly, survival rates for these cardiac emergencies remain unchanged despite the best efforts of healthcare providers. Now, organizations can leverage technology to help optimize team performance during these emergencies.

 

The Case for Better Tools, Teams, and Training

Dr. Ross began the webinar by making a case for bold changes in the critical components of resuscitation care. First, the statistics on survival rates for in-hospital cardiac arrest are disappointing. They hover somewhere around 20% nationally and there has been little improvement over the last 30 years. Secondly, The Centers for Medicare and Medicaid Services (CMS) have begun to investigate how to improve the care that is delivered during an in-hospital cardiac arrest and have begun citing hospitals for insufficient documentation. In addition, the Joint Commission has also released some new standards that require hospitals to collect, compile and analyze data related to these events and then use that data to improve performance.

 

Barriers to Better Performance 

Dr. Ross went on to share the common “pain points” that hospitals have when responding to a cardiac arrest. Format Health has identified the areas of opportunity most likely to be mentioned by hospitals:

  • Illegible, inaccurate, and incomplete paper records
  • Lack of availability of desktop devices at all code locations
  • Patient and performance documentation that needs improvement
  • Poor or insufficient strategies for following algorithms and guidelines
  • Lack of immediate access to code records for patient handoffs
  • Time associated with transcribing and sharing patient records and extracting data
  • Lost and incomplete records
  • Lack of insight into cardiac events that can improve future performance

The bad news is that it is difficult to improve adherence to the guidelines by simply doing what we have always done with the tools that we currently have. Using stopwatches, charting on gloves, bed linens and paper records simply does not work when trying to strictly adhere to algorithms and guidelines.

 

Tools That Support Improvement

Increased focus on performance from CMS and the Joint Commission will require a stricter adherence to guidelines. Dr. Ross shared that guidance does indeed make a difference. Citing a recent article in the Official Journal of the European Resuscitation Council, Dr. Ross shared a somewhat surprising statistic.  “A mere 10% increase in compliance can result in a 30% increase in the likelihood of spontaneous circulation,” said Dr. Ross. 

 

ReVitalPro

Format Health’s ReVitalPro provides a user-friendly interface that uses workflow tabs that enable the recorder to document the code quickly and accurately. With tabs for rhythms and vitals, cardioversion and pacing, medications, airways, lines and fluids and procedures, the recorder is only a click away from being able to quickly enter information about the code. In addition, the tabs are pre-populated with the most frequently used drugs and their doses, common procedures, and other relevant information to allow for accurate and rapid entry of information. When an item from a drop-down list is selected it is automatically time-stamped and added to the record.

“ReVitalPro was designed by clinicians to bring calmness and order to the chaos of an emergency. With built-in timers, dosage prompts and guideline reminders it can reduce variability and cognitive errors. In addition, it is the only solution that has been approved to integrate in-hospital cardiac arrest data with the American Heart Association’s Get With The Guidelines resuscitation registry,” said Dr. Ross.

 

Revisioning Teams

Individual performance is insufficient to deliver high-quality resuscitation care – ReVitalPro aims to help transform your team of experts into an expert team.  Michelle Howe shared that the recorder is an essential function in terms of critical clinical support, but that education and training for recorders is often inadequate and leaves them unprepared for their roles. Through the use of dosage calculators, safety prompts, timers, and guideline reminders, ReVitalPro enables the recorder to take an active role as a “navigator” who can provide the just-in-time information needed for the “ship captain,” or code leader, to make informed critical decisions to provide the best possible resuscitation care.

 

Decision Support and Guidance

CodeBlueIQ is a companion product to ReVitalPro that receives, compiles and reports data from every code. In addition to enabling a debrief of a single code event, the analytics dashboard also allows teams to identify performance patterns in guideline adherence. For example, the 21 “report cards” provide at a glance recognition of where teams are succeeding and where there may be room for improvement across issues like time off chest, speed of shock post-recognition of rhythm, or adherence to compressor switching guidelines. The system highlights any patient records that need further review and signature, allow for addition of addendums, and integrates code blue records directly into the patient’s Electronic Health Record.