Operating Room Codes Redefined: A Highly Reliable Model Integrating the Core Hospital Code Team.

Area of Science:

• Medical Education
• Patient Safety
• Healthcare Management

Background:

• Operating room (OR) cardiac arrests are typically managed by OR staff alone, unlike out-of-OR arrests managed by multidisciplinary teams.
• This can lead to missed opportunities for improved patient outcomes due to the absence of specialized code teams.
• Existing intraoperative code activation processes were inconsistent, varying by time and day.

Purpose of the Study:

• To develop and implement a reliable intraoperative emergency response system.
• To standardize respondents and roles for in-OR code events.
• To ensure consistent emergency response regardless of the time or day.

Main Methods:

• A multidisciplinary team at an academic pediatric hospital led the initiative.
• In situ simulations in the OR identified a consistent activation process as a key driver.
• Core hospital code team members were integrated into the OR response, with preassigned roles and education.

Main Results:

• A knowledge assessment showed perioperative staff achieved an average score of 96%.
• Subsequent OR codes demonstrated an improved initiation process and management.
• The standardized system ensured predictable code response across all times and days.

Conclusions:

• Standardized activation and roles for intraoperative code teams improve emergency response predictability.
• The initiative successfully created a reliable intraoperative emergency response system.
• Ongoing simulations are utilized to continuously optimize the process.