Resuscitation Perspectives: 6 Questions With A Critical Care Director

Code Blue events bring a new meaning to the concept of “a team effort.” When a code is called, a patient’s life is — quite literally — in the hands of the clinicians who respond. And to make matters more complex, code teams are often composed of clinicians from a variety of backgrounds and disciplines who may not routinely work together — except to collaborate on infrequent, unplanned, and high-stakes emergency events.

That’s the inspiration behind our Resuscitation Perspectives series, where we interview different members of Code Blue teams to better understand their role and impact in resuscitation response. And while our interviewees preferred to remain anonymous for privacy, we know their insights will resonate and inform readers across all Code Blue roles — from nurses and physicians to patients and families.

Resuscitation role spotlight: Critical care director

In our latest interview in the series, we hear from a critical care director at a university hospital. From a resuscitation standpoint, our interviewee’s role is focused on training, preparedness, and communication within Code Blue teams. Keep reading for insights on the “bird’s eye view” that this role offers, plus key takeaways on what goes into an effective Code Blue team.

Current role

What is your current role, and how are you involved with resuscitation/emergency response?

I am the director of a high-acuity critical care section at a university hospital in Manhattan. My role in resuscitation is focused on team preparedness, team coordination, and implementation of best practices.

How do the unique responsibilities of your role impact your perspective on emergency response?

My role allows me to have a bird’s eye view of how our individual practitioners respond to codes and how our teams provide care. I have an overall picture of what to work on in order to improve immediate outcomes, team dynamics, patient care, and overall outcomes for our patients’ long-term survival.

Impact on emergency response

What are some of the most important changes that you have driven, or been a part of, that improved resuscitation response?

I’m a firm believer that realistic scenarios are the best preparation for individuals and teams to respond to these high-stakes scenarios. Of late, my role has been to implement mock code training programs and high-fidelity training programs to study and improve team dynamics. We focus not only on the team’s actions during the event, but also the shared mental model and communication as well. I think that my work has greatly impacted both of those within my clinical settings.

Do you see your role as having an impact on improving patients’ survival?

I don’t think one single individual impacts survival in a cardiac arrest. Cardiac arrests are scenarios that require coordination, and coordination involves many players. But there does need to be a homogeneous understanding of where you want to drive patient care during that very high-stakes scenario, and that drive has to be understood by everybody. A team that works well will have a shared mental model of what is being implemented and how, with strong leadership and good coordination.

Reflecting on the past — and looking to the future — of resuscitation response

What is some advice you would give your younger self that you didn’t know then, but know now?

When I was younger, I didn’t understand the value of appropriate leadership. I thought that pushing from behind was the right way to go. Today, I think of the role of a leader in a completely different manner: somebody who pulls from the front.

That is a cultural change for me that I think translates very nicely to managing the cardiac arrest team. The overall management of the team comes from strong, empathic, and balanced leadership.

How do you see resuscitation response changing in the future?

I think we lag significantly in the utilization of technology in resuscitation compared to the technologies that we use on a day-to-day basis. Technology to help individual practitioners perform at their best is the way of the future.

Also, upgrading equipment: making equipment lighter, smarter, and more robust, along with an integration with systems of care in order to provide a more homogeneous and high-quality care for everybody.