Going Silent: Redesigning the Activation Process for In-Hospital Cardiopulmonary Arrests

Area of Science:

• Healthcare Operations
• Patient Safety
• Quality Improvement

Background:

• Reducing environmental noise is a key goal for health systems.
• Overhead paging systems contribute significantly to hospital noise levels.
• Silent notification systems offer a potential solution for noise reduction.

Purpose of the Study:

• To evaluate the feasibility and safety of transitioning from an overhead-activated to a silently activated in-hospital code team notification system.
• To assess the impact of this transition on environmental noise, code team communication, and key quality metrics.
• To determine if the change adversely affects response times or provider availability.

Main Methods:

• A 10-week preparation period preceded the transition.
• A three-step quality improvement approach was employed.
• Stakeholder input, preimplementation education, timed trials, and in situ simulation were utilized.

Main Results:

• No significant difference was observed in key quality metrics, including compliance with defibrillation, event survival, or survival to discharge.
• Provider survey data and "quiet at night" scores remained unchanged.
• The transition was deemed feasible and safe.

Conclusions:

• Transitioning to a silently activated code team system is achievable and safe.
• Abandoning overhead paging does not compromise essential quality metrics.
• The new system supports code team function without negative impacts.