Abstract 305: Practice How You Play! An Innovative Two-Pronged Approach at Improving Resident and Allied Health Staff Performance During Code Blue Events

Introduction/Background: Cardiopulmonary arrest (Code Blue or CB) is a feared complication of severe medical illnesses. In-hospital CB events (CBE) have been estimated to have a mortality rate of only 30.4%. CBEsare difficult to prepare for and execute due many factors, including their low frequency, high complexity, and unpredictability.

Research Questions/Hypothesis: Over 6 months (March - September 2019), we tested the effects of both adaptation of a Code Blue (CB) Team Leader (TL) checklist—aimed at improving resident leadership and communication—as well as implementation of an interdisciplinary in-hospital CB simulation to improve the performance of both resident physicians.

Methods/Approach: Primary outcomes included change in resident confidence leading a CBE (i.e. Level of comfort as TL , confidence of diagnosis and management, confidence in code-related procedural skills), and familiarity with the institutional rapid response protocol. Secondary outcomes included self-reported confidence of nurses to execute their role, and both physician and nurse time to response. Confidence parameters were measured by a 10 point Likert scale. Pre-intervention, baseline cross-sectional survey values of the primary outcome were obtained from 24 internal medicine residents (12 PGY2s, 12 PGY3) over 6 months. Post-intervention, the cross-sectional survey was repeated.

Results/Data (descriptive and inferential statistics): Statistics for residents displayed in table and figure 1. The level of nurse confidence increased from 7.5 to 8.25 over 5 months. The time to first response by residents has decreased by more than 50%. Conclusion(s) Our project improved the quality and resident level of comfort running Code Blue events among both residents and nurses.