Abstract PR582

Abstract

Case report: Background: A coordinated difficult airway (DA) management program at University of Rochester Medical Center (URMC) was necessary to prevent harm and adverse outcomes from DA management outside of the operating room, since there were no sufficient resources available for DA management during the off-hours and out-of-OR locations. Our goals were to improve quality of difficult and emergency airway management at out-of-OR locations, organize paging system to systematize arrival of multiple experienced personnel, and decrease the time to mobilize equipment. The Johns Hopkins Medicine (JHM) Difficult Airway Response Team (DART) Program is multidisciplinary, comprehensive DA program that reported no airway management-related deaths, malpractice claims or sentinel events in their first 5 years. URMC adapted and implemented the JHM DART Program for the management of DA outside the operating room. Methods: DART Steering Committee was established and included representatives from five clinical departments, including anesthesiology, otolaryngology, trauma surgery, critical care and emergency medicine. DART Steering Committee met regularly over the course of three months to lay the groundwork for implementation of the DART Program. JHM DART Program Oversight Team provided guidance in adapting the JHM DART Program to align with resources at URMC. Efforts focused on: determining the composition of the team; developing criteria for summoning the team; establishing a unified telecommunications response system, developing a fully equipped DA carts, educating staff about the existence of DART and criteria for when to summon it. JHM DART Program formal consultation which included on-site visits, on-going conference calls, and sharing of DART Tool Box documents for URMC DART Program modification facilitated timeline for a comprehensive program. Results: URMC’s innovative members adapted the JHM DART Program within 3 months of initiating this project. URMC DART Team was established and implemented with providers from five departments and DART Policy was accepted with instructions about DART activation, equipment delivery, and providers’ responsibility. Educational component of DART Program, Multidisciplinary Difficult Airway Course, was implemented for senior residents and fellows from five DART Departments targeting 100% participation. Conclusion: Implementation or the DART Program at URMC established the team which is capable of delivering the highest-quality and safest patient-centered care during difficult airway management at our institution. First year URMC results will be analyzed and collaborative lessons learned will be shared with providers wanting to adapt a DART Program to their institution. Disclosure of Interest: None declared