Finding the key to a better code: code team restructure to improve performance and outcomes

Area of Science:

• Emergency Medicine
• Healthcare Quality Improvement
• Team Dynamics in Critical Care

Background:

• Code teams are crucial for responding to life-threatening patient events.
• Deficiencies in medical skills or non-medical qualities can impair resuscitation effectiveness.
• A structured approach is needed to optimize code team performance.

Purpose of the Study:

• To implement and evaluate an evidence-based quality improvement restructuring plan for a hospital code team.
• To enhance the effectiveness and efficiency of in-hospital resuscitation efforts.

Main Methods:

• A 3-month restructuring plan included defining team size, roles, and positions.
• Initiated team training events and surprise mock code simulations.
• Collected data via electronic questionnaires and measured time-to-defibrillation from code summary sheets.

Main Results:

• Significant improvements in team member confidence and role clarity were observed.
• Minor enhancements noted in team leadership and reduction of noise during codes.
• Average time-to-defibrillation decreased annually post-restructure.

Conclusions:

• Code team restructuring positively impacts team functioning and resuscitation efficiency.
• Decreased time-to-defibrillation indicates improved patient care and outcomes.
• The initiative provides benefits to team members, the institution, and patients.