An interdisciplinary care model was implemented in January 2020 to improve cardiopulmonary resuscitation care outcomes. Through consistent collaboration of a Physician Champion, a Clinical Nurse Specialist (CNS), a Registered Nurse Quality Specialist, and Quality Data Abstractors, implementation of evidence-based strategies resulted in sustained improvements in nationally recognized resuscitative quality measures. The combined efforts of the team established institutional-wide awareness engaging healthcare professionals across the spectrum, from hospital administration to frontline healthcare professionals. Accomplishments included the hospital receiving award-recognition for two consecutive years from the American Heart Association’s quality improvement program.
Problem: The primary goals of the interdisciplinary team were to improve the workflow of data collection, standardize documentation, and ultimately increase compliance of the GWTG- Resuscitation programs cardiopulmonary resuscitation (CPR) care measures.
Measurement: An Ishikawa diagram and value stream map revealed gaps in data collection. Data was collected and entered into the AHA registry, at which point compliance of the four GWTG measures were evaluated. After completion of case reviews, line graphs and column charts were created to track results.
Analysis: GWTG compliance required >85% for all measures, which included: confirmation of airway, time to first shock <2 minutes for VF/pulseless VT, time to IV/IO epinephrine <5 minutes for asystole/PEA, and percent of pulseless cardiac events monitored. A slide deck was then created for the CNS to present to committees.
Implementation: To decrease documentation variations, CNS and Physician Champion revised forms and created a standardized template. To improve electronic data availability, Health Information Management facilitated. CNS assigned Code roles to ICU personnel (1,2), provided education, performed monthly mock codes (1), and completed weekly form reviews contacting clinicians involved with documentation discrepancies.
Results/Discussion: We attained award-recognition by accomplishing >85% compliancy for all measures in 2022 and 2023. Through the interdisciplinary approach and implementation of evidence-based strategies, we established institutional-wide awareness engaging healthcare professionals across the spectrum. We will continue to improve by ensuring success through the collective actions of everyone on the team.
