A performance improvement-based resuscitation programme reduces arrest incidence and increases survival from in-hospital XXXX .

@entity1 @entity204 @entity1167
BACKGROUND: Traditional resuscitation training models are inadequate to achieving and maintaining resuscitation competency. This analysis evaluates the effectiveness of a novel, performance improvement-based inpatient resuscitation programme. METHODS: This was a prospective, before-and-after study conducted in an urban, university-affiliated hospital system. All inpatient adult @entity1167 without an active Do Not Attempt Resuscitation order from July 2005 to June 2012 were included. The advanced resuscitation training (ART) programme was implemented in Spring 2007 and included a unique treatment algorithm constructed around the capabilities of our providers and resuscitation equipment, a training programme with flexible format and content including early recognition concepts, and a comprehensive approach to performance improvement feeding directly back into training. Our inpatient resuscitation registry and electronic @entity1 care record were used to quantify arrest rates and survival-to-hospital discharge before and after ART programme implementation. Multiple logistic regression analysis was used to adjust for age, gender, location of arrest, initial rhythm, and time of day. RESULTS: A total of 556 @entity1167 were included (182 pre- and 374 post-ART). Arrest incidence decreased from 2.7 to 1.2 per 1000 @entity1 discharges in non-ICU inpatient units, with no change in ICU arrest rate. An increase in survival-to-hospital discharge from 21 to 45% (p<0.01) was observed following ART programme implementation. Adjusted odds ratios for survival-to-discharge (OR 2.2, 95% CI 1.4-3.4) and good neurological outcomes (OR 3.0, 95% CI 1.7-5.3) reflected similar improvements. Arrest-related @entity204 decreased from 2.1 to 0.5 @entity204 per 1000 @entity1 discharges in non-ICU areas and from 1.5 to 1.3 @entity204 per 1000 @entity1 discharges in ICU areas, and overall hospital mortality decreased from 2.2% to 1.8%. CONCLUSIONS: Implementation of a novel, performance improvement-based inpatient resuscitation programme was associated with a decrease in the incidence of @entity1167 and improved clinical outcomes.
