The Resuscitation QI Bundle
Because of the high mortality of cardiac arrest, a number of the clinical teams at various hospitals have created and implemented a resuscitation quality improvement (QI) program based on evidence-based guidelines.
In order for us to meet our goal of improving care, we must provide actionable information for providers to be able to modify their behaviors, processes, or systems of care. Tools that facilitate data use for care improvement include patient lists, decision support tools (typically based on clinical practice guidelines), and patient- and population-level reporting systems. Importantly, it is not the embedding of the tools in the project but the use of the tools by the providers who participate in the project to improve the care they provide, and the use of the QI data to measure that improvement. This QI project will utilize the collection of current QI data with the goal of improving quality of cardiac arrest care at the population and individual patient levels.
The majority of research has focused on fixing a specific individual intervention of care during cardiac arrest and the individual steps during and after resuscitation. However, it is likely that more than one element, rather a novel “bundling” of many evidence-based quality improvement interventions, will achieve the greatest improvement in the quality and safety of care to effect improved patient survival and outcomes.
The QI Bundle is comprised of 6 Components
Screening and identification of patients at the highest risk for cardiac arrest.
Brief (5 minute) immediate post-event feedback, discussion, and emotional processing of arrest event.
Staff bedside preparation and "refreshing" of psychomotor skills and pre-arrest preparation.
Review, confirmation, and communication of optimal post arrest management.
Supplementary feedback to optimize CPR delivery and cognitively unload the Resuscitation Leader.
Multi-disciplinary review utilizing event and patient data to discuss process of care and team performance.