When it comes to the Code Blue care cycle, there are a lot of moving parts. From early warning signs to post-arrest care and more, any number of variables can ultimately affect a patient’s outcome. Throw in the urgent, high-stakes nature of the event, and it can be challenging for any single Code Blue response team to take a step back and determine which variables to tweak and improve over time.
At many hospitals, this is where a resuscitation committee comes in. It might go by a different title at your hospital (e.g., “code committee”), but regardless of the naming convention, the group’s overarching goal is the same: to evaluate resuscitation response across the hospital, spot trends, and improve quality.
If your hospital is in the early stages of forming a committee, see our tips for getting started. But if you’re looking for ways to optimize an existing committee, you’ve come to the right place. In this article, we’ll focus on committee meetings in particular. Keep reading to learn strategies to use before, during, and after the resuscitation committee meeting to maximize productivity and impact.
First things first: Committee goals & objectives
To start, be sure to establish (and regularly review) the goals and objectives of the resuscitation committee. This clarity helps the committee stay on track and prioritize during any given meeting and throughout the year. Specifics will vary per hospital, but a resuscitation committee’s charge might include:
- Creating and maintaining resuscitation policies and protocols
- Reviewing individual Code Blue cases and problem-solving barriers to optimal response
- Determining resuscitation training requirements: schedules and frequency of training, Mock Code requirements (in situ and simulation), code team design and role-specific training
- Recommending continuous quality improvement (CQI) initiatives and monitoring progress (for example, with key performance indicators)
- Communicating resuscitation policy changes to staff
- Reporting findings to an executive committee annually or as needed
- Addressing additional topics as they arise
The responsibilities will likely evolve over time to reflect new and changing priorities. It’s a smart strategy to build in regular opportunities to revisit and refine the list. For example, your committee members might find it helpful to create strategic goals for the group yearly. They can then dedicate the first 10 minutes of every meeting to check-in on their progress.
Before the resuscitation committee meeting: Planning & preparation
Although committees aren’t expected to tackle all the items above at any single meeting, one thing is clear: there’s a lot of ground to cover. This is where a little pre-meeting organization and preparation can go a long way. It’s important for someone to own this process, so if you haven’t already, make sure to assign a committee organizer to take on the pre-meeting tasks. Then focus on the following:
- Stick to a set frequency for meetings. Aim for the sweet spot that allows the resuscitation committee to maintain momentum during meetings and take meaningful action in between. For many hospitals, monthly works best. But if that’s not feasible, make sure meetings occur quarterly at a minimum. Anything less frequent can limit engagement and effectiveness.
- Get meetings on the calendar early to minimize scheduling conflicts. It’s easier for committee members to schedule other obligations around a standing meeting series than to find time in an already-packed schedule. This is especially important if your committee struggles to secure at least 50% attendance — the minimum needed to hold the meeting.
- Send out the meeting agenda at least 1 to 2 days before, with approximate time blocks for each item. Sharing the topics ahead of time makes for a richer, more productive discussion. See below for a sample agenda.
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- Collect data in advance. The committee can’t assess current performance and make future recommendations without accurate, usable data, so it pays off to proactively compile that information beforehand. Your committee may need a combination of aggregate data (number and location of cardiac arrests, response time, cardiopulmonary resuscitation quality, outcomes, etc.) and data from individual Code Blue cases — so customize the data compilation process accordingly.
Tip: Pre-meeting data compilation is often onerous, especially for hospitals that use paper-based methods to document codes. But switching to an electronic documentation tool can help. For example, CoDirector® Resuscitation Software from Nuvara® includes built-in software prompts to aid data collection during the code. It also compiles both individual and aggregate code data into easy-to-digest reports — perfect for committee review and analysis.
During the resuscitation committee meeting: Compliance & CQI
Compliance
Compliance is a hospital-wide initiative, not the responsibility of any one committee alone. But since resuscitation committees often have a bird’s-eye view of performance, outcomes, and barriers, they can (and should) play a direct role.
Depending on the accrediting body and your hospital’s strengths and weaknesses, the committee’s focus might include compliance topics such as:
- Filling out code documentation properly for completeness, accuracy, and consistency
- Adherence to Advanced Cardiac Life Support standards
- Crash cart safety: cart checks, equipment safety and readiness, etc.
- And more
Continuous quality improvement (CQI)
Although it’s smart for hospitals to focus some of the committee’s efforts on compliance, the work doesn’t stop there.
The most effective resuscitation committees are those that relentlessly pursue CQI. They know that small improvements add up to big change over time, and they celebrate progress without becoming complacent.
To cultivate this mindset, encourage your committee to constantly re-evaluate every aspect of Code Blue care: training, response, code cart configuration, post-arrest care, and more. And then ask the questions:
- What are we missing in this area?
- How can we improve?
- How can we support our staff with the right tools, trainings, and resources to improve care?
After the resuscitation committee meeting: Communication & outreach
Lastly, if the resuscitation committee’s analysis and takeaways never leave the meeting room, change isn’t going to stick — or happen at all. So what’s the best way to share the committee’s findings and take action?
For committee members, send a brief meeting summary with action items after every meeting. This keeps the momentum going and ensures everyone is on the same page.
For staff and other stakeholders who are not on the committee, the answer will depend on the topic, who needs to be informed, and your hospital’s culture. Post-meeting communication with these groups might look like:
- Sharing key takeaways at the next staff-wide cold debrief
- Issuing brief “report cards” of recent Code Blue cases that the committee evaluated
- Reporting on a regular basis (or as needed) to an executive committee, particularly for larger initiatives that require funding and support
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Nuvara can help
Your hospital’s resuscitation committee relies on accurate data to drive decision making. From detailed data collection during the code to analysis afterward, see how Nuvara’s CoDirector Resuscitation Software can help.
Sources
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The Joint Commission. (2021). R3 Report: Resuscitation Standards for Hospitals. Available at: r3-report_resuscitation_hap_final_.pdf (jointcommission.org)
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Edelson, D. P., Yuen, T. C., Mancini, M. E., et. al. (2014). Hospital cardiac arrest resuscitation practice in the United States: A nationally representative survey. Journal of Hospital Medicine, 9(6), 353–357. https://doi.org/10.1002/jhm.2174
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Nallamothu, B. K., Guetterman, T. C., Harrod, M., et. al. (2018). How do resuscitation teams at top-performing hospitals for in-hospital cardiac arrest succeed? Circulation, 138(2), 154–163. https://doi.org/10.1161/circulationaha.118.033674