Improving Acute Resuscitation Plan Completion Rates Using Visual Aids in an Inpatient Setting: A Quality Improvement...

Background An Acute Resuscitation Plan (ARP) is a document that helps medical professionals incorporate the wishes of patients and their families, as well as the opinions of the treating team, when making decisions about treatment escalation and whether resuscitation is appropriate should a patient clinically deteriorate. This project aimed to assess if the use of visual aids increased the completion rate of ARPs in an inpatient cardiology setting. Methods We completed a two-cycle quality improvement study using the plan-do-study-act framework, starting with an initial audit before introducing interventions in the form of visual aids over three weeks. Re-auditing occurred each week to assess the impact of the interventions on inpatient ARP completion. Results The baseline audit, conducted prior to any interventions, showed an ARP completion rate of 16% across all patients admitted under cardiology. After the first cycle of the project involving the introduction of posters and a change to the cardiology doctor's ward list, the ARP completion rate increased to 47.6% (p = 0.027). After a second cycle, introducing further visual aids attached to mobile workstations, the ARP completion rate rose to 52.2% (p = 0.014), showing a significant rise compared to baseline. Conclusions This project demonstrated that the use of visual aids significantly increased the rate of ARP completion in an inpatient cardiology setting. To further assess the success of these interventions, we suggest expanding this project hospital-wide and monitoring the ARP completion rate over a prolonged period to demonstrate the effectiveness of these interventions in the longer term.