Giving Compass' Take:

• Brahmajee Nallamothu explains how some hospitals are dramatically more successful in address cardiac arrests than others thanks to effective Code Blue response plans. 

• How can funders help hospitals improve their Code Blu response plans? 

• Learn about progress in addressing heart disease in the U.S.

About 200,000 cardiac arrests happen each year in U.S. hospitals. Nearly 80 percent of patients do not survive.

This begs an important question. In 2018, do hospital leaders even know how Code Blue teams should be optimally designed and deployed to tackle in-hospital cardiac arrests?

Some treatments, like defibrillation, can reverse cardiac arrest if applied promptly. If delayed, however, death is inevitable, even with treatment. About 4 of 5 patients who have cardiac arrests in the hospital do not survive.

In one study differences in death rates between the top and bottom 10 percent of hospitals were almost two-fold. My colleagues and I have spent the last two years trying to understand potential reasons for why such variability exists.

This is especially puzzling since providers typically follow the same guidelines for CPR and advanced cardiac life support that are established regularly by the American Heart Association.

To understand this issue better, we performed a qualitative study by visiting nine hospitals over the last two years at the extremes of performance for cardiac arrest and talked with administrators, quality and patient safety personnel, and most importantly, doctors, nurses and other clinical staff that were boots on the ground. We visited both types to get a sense of performance across the spectrum.

We found that some top hospitals had teams with members dedicated to responding to cardiac arrests around the clock. Others we discovered had members who could be responsible for other patients during work hours, but, preemptively, systems were set in place for them to immediately drop these duties and respond when needed.

Our research found that top hospitals have explored innovative models to get more consistent results. One hospital with residents had senior doctors with more experience also respond to support residents.

Finally, the top hospitals also trained providers – including residents – differently, using strategies like “realistic” mock codes.

Read the full article about cardiac arrest survival rates by Brahmajee Nallamothu at The Conversation.