Exploring Strategies to Improve Cardiac Arrest Survival Proceedings of a Workshop (2017) / Chapter Skim
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6 Enhancing Hospital Response to Cardiac Arrest
6 Enhancing Hospital Response to Cardiac Arrest
Pages 85-98
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From page 85... ...
. CURRENT EFFORTS TO ACHIEVE HOSPITAL ACCREDITATION AND ACCOUNTABILITY IN CARDIAC ARREST Mimi Peberdy, Virginia Commonwealth University Hospitals' responses to cardiac arrest vary substantially across the United States, said Mimi Peberdy.
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From page 86... ...
systems, health care systems, and hos pitals should adopt formal, continuous quality improvement programs for cardiac arrest response that • ssign responsibility, authority, and accountability within each organization a or agency for specific cardiac arrest measures; • mplement core technical and non-technical training, simulation, and de i briefing protocols to ensure that EMS and hospital personnel can respond competently to both adult and pediatric cardiac arrests; and • ctively collaborate and share data to facilitate national, state, and local a benchmarking for quality improvement.
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From page 87... ...
Resuscitation team composition and training offer other opportunities to enhance survival rates. Current Joint Commission standards generally require hospitals to have resuscitation services and equipment available, a trained response team, and data collection to monitor performance.
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From page 88... ...
The report recommended a set of core measures meant to improve health, quality, cost, and engagement. The participant suggested that the resuscitation field may be better served if all hospitals and EMS systems track and report outcomes along with the best practices associated with changes in outcomes rather than asking the Joint Commission to assess specific process measures.
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From page 89... ...
The predominant causes of cardiac arrest in children are usually respiratory or hypoxic in nature, unlike the underlying coronary artery disease that often leads to arrest in adults, noted Nadkarni. At birth many babies require some form of immediate stimulation, whereas only 3 to 6 percent of the 136 million births annually worldwide require bag-and-mask ventilation and less than 1 percent require more advanced resuscitation (e.g., CPR, medication)
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From page 90... ...
Specifically, Nadkarni highlighted obstacles in training teams and assessing performance in simulated environments and then being able to correlate simulated performance with real performance and meaningful clinical outcomes data. In response to a question about the possible benefits and opportunities for collecting cardiac arrest data in hospitals, Nadkarni stated that the use of electronic health records (EHRs)
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From page 91... ...
Because many of the cardiac arrest processes are time critical, identifying start and end points and measuring time as a reliable and synchronized variable are beneficial. Dianne Atkins, the planning committee member who moderated this panel, described a CPR navigator module that her health care system designed to collect cardiac arrest data.
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From page 92... ...
However, in considering the development and application of process measures, Septimus said that all process measures must be linked to better outcomes; unintended consequences must be considered when developing and implementing new process measures; and reportable measures must not create a sizable burden on health care providers. Building on the synergy of the PCAST report, NQF and CDC partnered with a group of public- and private-sector leaders -- the Antibiotic Stewardship Action Team -- in 2015 to develop the guide National Quality Partners Playbook: Antibiotic Stewardship in Acute Care (NQF, 2016)
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From page 93... ...
BREAKOUT SESSION REPORT: IMPROVING THE QUALITY OF HOSPITAL RESPONSE TO CARDIAC ARREST Dianne Atkins, Planning Committee Member1 Atkins facilitated a breakout session on improving the quality of hospital response to cardiac arrest, which responded to the fourth recommendation in the IOM's report (see Appendix A)
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From page 94... ...
Three participants described limitations of current coding systems, noting that the lack of separate codes for in-hospital, out-of-hospital, and pediatric cardiac arrests created problems when trying to conduct research related to cardiac arrests that occur in a specific setting or population. One of these participants also noted that the lack of available coding for specific cardiac arrest therapies (e.g., therapeutic temperature management)
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From page 95... ...
codes (e.g., American Medical Association, National Center for Health Statistics) • overnment Agencies: For example, Centers for Medicare & Medicaid G Services • ndustry I • atient and Family Advocacy Organizations P • rofessional Organizations: For example, American Academy of Pedi P atrics, American Heart Association, American Hospital Association, Chil dren's Hospital Association, Society for Critical Care Medicine, Society of Hospital Medicine SOURCE: Presented by Dianne Atkins, July 12, 2016, A Dissemination Workshop on the Report Strategies to Improve Cardiac Arrest Survival: A Time to Act.
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From page 96... ...
Prepared for the American Heart Association's Get With the Guidelines-Resuscitation Investigators. Circulation: Cardiovascular Quality and Outcomes 7(4)
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From page 97... ...
2016. Enhancing hospital response to cardiac arrest.
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