Abstract 326: The Impact of a Critical Care Outreach Team on the Collection of In-Hospital Cardiac Arrest Resuscitation Quality Data

Abstract

Introduction: Critical Care Outreach Teams (CCOTs) serve to recognize clinical deterioration and respond to rapid response activations prior to in-hospital cardiac arrest (IHCA) in non-intensive care unit (ICU) patient care areas. In some hospitals, the CCOT operates separately from the IHCA resuscitation team. However, limited data exist regarding the outcomes of CCOT and IHCA resuscitation team collaboration during IHCA. Research Question: The purpose of this pilot study was to determine if the addition of a CCOT member to an IHCA resuscitation team would improve the collection of quality metrics during adult IHCA resuscitations. Goals: The primary goal of this study was to increase the documentation of two quality metrics identified by the American Heart Association’s Get with the Guidelines®-Resuscitation (AHA GWT-R) program during adult IHCAs in non-ICU patient care areas: 1) documentation of initial pulseless rhythm and 2) documentation of time to first intervention (epinephrine or defibrillation). The secondary goal was to increase the percentage of completed IHCA records/code sheets integrated into the electronic medical record (EMR). Methods: All non-ICU IHCAs that occurred prior to the intervention during a year-long period (June 1 st , 2021, to May 31 st , 2022) were used to establish baseline resuscitation quality metrics. During the intervention period (June 1 st , 2022, to May 31, 2023), a member of the CCOT responded to inpatient IHCA activations to serve as the designated event recorder and assist with the resuscitation. At the end of the study period, all IHCA activations were reviewed. Results: There were 74 IHCAs in the pre-intervention group and 76 IHCAs in the post-intervention group. In the post-intervention group, integration of IHCA records/code sheets into the EMR increased in the post-intervention group from 56.8% (42/74) to 96% (73/76). In the post-intervention group, there was also an increase in the documentation of initial pulseless rhythm from 75.7% (56/74) to 96% (73/76) and documentation of the first intervention from 71.4% (n=40) to 98.6% (n=72). Conclusions: This pilot demonstrated that adding a CCOT member to non-ICU IHCA resuscitations improves the accuracy of IHCA documentation and AHA GWT-R quality metrics.