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Checklists and consistency of care after resuscitation from in‐hospital cardiac arrest: A pilot study
Background In‐hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes. Objective Inconsistencies in post‐ROSC care exist and we sought to find a low cost way to decrease this variability. Designs, Settin...
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| Published in: | Journal of hospital medicine 2023-08, Vol.18 (8), p.677-684 |
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| container_title | Journal of hospital medicine |
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| creator | Raikhel, Andrew V. Carlbom, David J. Ferraro, Stephen Schulte, Vera Johnson, Nicholas J. Town, James A. |
| description | Background
In‐hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes.
Objective
Inconsistencies in post‐ROSC care exist and we sought to find a low cost way to decrease this variability.
Designs, Settings, and Participants
We obtained pre and post intervention metrics including percentage of IHCA with a timely electrocardiogram (ECG), arterial blood gas (ABG), physician documentation, and documentation of patient surrogate communication after ROSC.
Intervention
We developed and implemented a post‐ROSC checklist for IHCA and measured post‐ROSC clinical care delivery metrics at our hospital during a 1‐year pilot period.
Main Outcome and Results
After the introduction of the checklist, 83.7% of IHCA had an ECG within 1 h of ROSC, compared to a baseline of 62.8% (p = 0.01). The rate of physician documentation within 6 h of ROSC was 74.4% after introduction of the checklist, compared to a baseline of 49.5% (p |
| doi_str_mv | 10.1002/jhm.13149 |
| format | article |
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In‐hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes.
Objective
Inconsistencies in post‐ROSC care exist and we sought to find a low cost way to decrease this variability.
Designs, Settings, and Participants
We obtained pre and post intervention metrics including percentage of IHCA with a timely electrocardiogram (ECG), arterial blood gas (ABG), physician documentation, and documentation of patient surrogate communication after ROSC.
Intervention
We developed and implemented a post‐ROSC checklist for IHCA and measured post‐ROSC clinical care delivery metrics at our hospital during a 1‐year pilot period.
Main Outcome and Results
After the introduction of the checklist, 83.7% of IHCA had an ECG within 1 h of ROSC, compared to a baseline of 62.8% (p = 0.01). The rate of physician documentation within 6 h of ROSC was 74.4% after introduction of the checklist, compared to a baseline of 49.5% (p < 0.01). The percentage of IHCA with ROSC that completed all four of the critical post‐ROSC tasks after the introduction of the post‐ROSC checklist was 51.1% as compared to 19.4% before implementation (p < 0.01).
Conclusions
Our study demonstrated improved consistency in completing post‐ROSC clinical tasks after the introduction of a post‐ROSC checklist to our hospital. This work suggests that the implementation of a checklist can have meaningful impacts on task completion in the post‐ROSC setting. Despite this, considerable inconsistencies in post‐ROSC care persisted after the intervention indicating the limits of checklists in this setting. Future work is needed to identify interventions that can further improve post‐ROSC processes of care.</description><identifier>ISSN: 1553-5592</identifier><identifier>EISSN: 1553-5606</identifier><identifier>DOI: 10.1002/jhm.13149</identifier><identifier>PMID: 37306095</identifier><language>eng</language><publisher>United States: Frontline Medical Communications</publisher><subject>Cardiac arrest ; Cardiopulmonary Resuscitation ; Checklist ; Documentation ; Electrocardiography ; Heart Arrest - therapy ; Hospitals ; Humans ; Intervention ; Pilot Projects</subject><ispartof>Journal of hospital medicine, 2023-08, Vol.18 (8), p.677-684</ispartof><rights>2023 Society of Hospital Medicine</rights><rights>2023 Society of Hospital Medicine.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3539-3701a73d586ed7666596e5aa59f9f9f3cf8334e7a6bdb26be7c0214c5ff0908d3</citedby><cites>FETCH-LOGICAL-c3539-3701a73d586ed7666596e5aa59f9f9f3cf8334e7a6bdb26be7c0214c5ff0908d3</cites><orcidid>0000-0003-1630-7106</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37306095$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Raikhel, Andrew V.</creatorcontrib><creatorcontrib>Carlbom, David J.</creatorcontrib><creatorcontrib>Ferraro, Stephen</creatorcontrib><creatorcontrib>Schulte, Vera</creatorcontrib><creatorcontrib>Johnson, Nicholas J.</creatorcontrib><creatorcontrib>Town, James A.</creatorcontrib><title>Checklists and consistency of care after resuscitation from in‐hospital cardiac arrest: A pilot study</title><title>Journal of hospital medicine</title><addtitle>J Hosp Med</addtitle><description>Background
In‐hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes.
Objective
Inconsistencies in post‐ROSC care exist and we sought to find a low cost way to decrease this variability.
Designs, Settings, and Participants
We obtained pre and post intervention metrics including percentage of IHCA with a timely electrocardiogram (ECG), arterial blood gas (ABG), physician documentation, and documentation of patient surrogate communication after ROSC.
Intervention
We developed and implemented a post‐ROSC checklist for IHCA and measured post‐ROSC clinical care delivery metrics at our hospital during a 1‐year pilot period.
Main Outcome and Results
After the introduction of the checklist, 83.7% of IHCA had an ECG within 1 h of ROSC, compared to a baseline of 62.8% (p = 0.01). The rate of physician documentation within 6 h of ROSC was 74.4% after introduction of the checklist, compared to a baseline of 49.5% (p < 0.01). The percentage of IHCA with ROSC that completed all four of the critical post‐ROSC tasks after the introduction of the post‐ROSC checklist was 51.1% as compared to 19.4% before implementation (p < 0.01).
Conclusions
Our study demonstrated improved consistency in completing post‐ROSC clinical tasks after the introduction of a post‐ROSC checklist to our hospital. This work suggests that the implementation of a checklist can have meaningful impacts on task completion in the post‐ROSC setting. Despite this, considerable inconsistencies in post‐ROSC care persisted after the intervention indicating the limits of checklists in this setting. Future work is needed to identify interventions that can further improve post‐ROSC processes of care.</description><subject>Cardiac arrest</subject><subject>Cardiopulmonary Resuscitation</subject><subject>Checklist</subject><subject>Documentation</subject><subject>Electrocardiography</subject><subject>Heart Arrest - therapy</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Intervention</subject><subject>Pilot Projects</subject><issn>1553-5592</issn><issn>1553-5606</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNp10MFOwyAYB3BiNG5OD76AIfGih25QCm29LYs6zYwXPTeUgmO2ZUIb05uP4DP6JDK7eTAxHOAjv_zz5Q_AKUZjjFA4WS2rMSY4SvfAEFNKAsoQ29-9aRoOwJFzK4QiktDoEAxITBBDKR2Cl9lSitdSu8ZBXhdQmNr5Qdaig0ZBwa2EXDXSQitd64RueKNNDZU1FdT118fn0ri1_y03ttBcQG49ba7gFK51aRromrbojsGB4qWTJ9t7BJ5vrp9m82DxeHs3my4CQShJAxIjzGNS0ITJImaM0ZRJyjlN1eYQoRJCIhlzlhd5yHIZCxTiSFClUIqSgozARZ-7tuat9XtklXZCliWvpWldFiYhxTSKcejp-R-6Mq2t_XZeRRQllLDUq8teCWucs1Jla6srbrsMo2zTfubbz37a9_Zsm9jmlSx-5a5uDyY9eNel7P5Pyu7nD33kNw6Pj4Y</recordid><startdate>202308</startdate><enddate>202308</enddate><creator>Raikhel, Andrew V.</creator><creator>Carlbom, David J.</creator><creator>Ferraro, Stephen</creator><creator>Schulte, Vera</creator><creator>Johnson, Nicholas J.</creator><creator>Town, James A.</creator><general>Frontline Medical Communications</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1630-7106</orcidid></search><sort><creationdate>202308</creationdate><title>Checklists and consistency of care after resuscitation from in‐hospital cardiac arrest: A pilot study</title><author>Raikhel, Andrew V. ; Carlbom, David J. ; Ferraro, Stephen ; Schulte, Vera ; Johnson, Nicholas J. ; Town, James A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3539-3701a73d586ed7666596e5aa59f9f9f3cf8334e7a6bdb26be7c0214c5ff0908d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Cardiac arrest</topic><topic>Cardiopulmonary Resuscitation</topic><topic>Checklist</topic><topic>Documentation</topic><topic>Electrocardiography</topic><topic>Heart Arrest - therapy</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Intervention</topic><topic>Pilot Projects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Raikhel, Andrew V.</creatorcontrib><creatorcontrib>Carlbom, David J.</creatorcontrib><creatorcontrib>Ferraro, Stephen</creatorcontrib><creatorcontrib>Schulte, Vera</creatorcontrib><creatorcontrib>Johnson, Nicholas J.</creatorcontrib><creatorcontrib>Town, James A.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of hospital medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Raikhel, Andrew V.</au><au>Carlbom, David J.</au><au>Ferraro, Stephen</au><au>Schulte, Vera</au><au>Johnson, Nicholas J.</au><au>Town, James A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Checklists and consistency of care after resuscitation from in‐hospital cardiac arrest: A pilot study</atitle><jtitle>Journal of hospital medicine</jtitle><addtitle>J Hosp Med</addtitle><date>2023-08</date><risdate>2023</risdate><volume>18</volume><issue>8</issue><spage>677</spage><epage>684</epage><pages>677-684</pages><issn>1553-5592</issn><eissn>1553-5606</eissn><abstract>Background
In‐hospital cardiac arrest (IHCA) with the return of spontaneous circulation (ROSC) is a clinical scenario associated with potentially devastating outcomes.
Objective
Inconsistencies in post‐ROSC care exist and we sought to find a low cost way to decrease this variability.
Designs, Settings, and Participants
We obtained pre and post intervention metrics including percentage of IHCA with a timely electrocardiogram (ECG), arterial blood gas (ABG), physician documentation, and documentation of patient surrogate communication after ROSC.
Intervention
We developed and implemented a post‐ROSC checklist for IHCA and measured post‐ROSC clinical care delivery metrics at our hospital during a 1‐year pilot period.
Main Outcome and Results
After the introduction of the checklist, 83.7% of IHCA had an ECG within 1 h of ROSC, compared to a baseline of 62.8% (p = 0.01). The rate of physician documentation within 6 h of ROSC was 74.4% after introduction of the checklist, compared to a baseline of 49.5% (p < 0.01). The percentage of IHCA with ROSC that completed all four of the critical post‐ROSC tasks after the introduction of the post‐ROSC checklist was 51.1% as compared to 19.4% before implementation (p < 0.01).
Conclusions
Our study demonstrated improved consistency in completing post‐ROSC clinical tasks after the introduction of a post‐ROSC checklist to our hospital. This work suggests that the implementation of a checklist can have meaningful impacts on task completion in the post‐ROSC setting. Despite this, considerable inconsistencies in post‐ROSC care persisted after the intervention indicating the limits of checklists in this setting. Future work is needed to identify interventions that can further improve post‐ROSC processes of care.</abstract><cop>United States</cop><pub>Frontline Medical Communications</pub><pmid>37306095</pmid><doi>10.1002/jhm.13149</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-1630-7106</orcidid></addata></record> |
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| ispartof | Journal of hospital medicine, 2023-08, Vol.18 (8), p.677-684 |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Cardiac arrest Cardiopulmonary Resuscitation Checklist Documentation Electrocardiography Heart Arrest - therapy Hospitals Humans Intervention Pilot Projects |
| title | Checklists and consistency of care after resuscitation from in‐hospital cardiac arrest: A pilot study |
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