Acute Care/Hospitalization

Simulation exercise for hospital resuscitation teams pinpoints training and patient safety issues

Simulating real-world medical emergencies can help medical staff prepare for actual events. When a newly constructed hospital employed simulation to familiarize its cardiac resuscitation team (Code Blue Team) with the layout of the facility, researchers were able to identify several measures that could improve staff response times and patient safety.

Jose F. Pliego, M.D., of Texas A&M Health Science Center College of Medicine, and colleagues examined the response of a hospital's Code Blue Team members as they practiced 12 mock code exercises. They found that 67 percent of Code Blue Team members readily knew where their assistance was needed, but 32 percent did not. The authors suggest that a classroom-based orientation for a new facility is insufficient for ensuring that staff can rapidly reach a location where a code was being called. The simulation also uncovered the problems of nonfunctioning overhead speakers, locked stairways, and elevators that did not let passengers override other floor requests that prevented Code Blue Team members from promptly responding to a code.

Practice guidelines indicate that the shorter the time a patient must wait to be resuscitated, the better his or her chance of survival. At this hospital, the average time for the first medical staff member to arrive was 42 seconds. However, for 7 of the 12 mock codes, the first responder was not a member of the Code Blue Team. This led to the recognition that non-Code Blue Team members should receive additional cardiac resuscitation training because they are often charged with managing a patient in cardiac arrest before the Code Blue Team members arrive.

This study was funded in part by the Agency for Healthcare Research and Quality (HS16634).

See "Using simulation to orient Code Blue Teams to a new hospital facility," by Frank J. Villamaria, M.D., M.P.H., Dr. Pliego, Hania Wehbe-Janek, Ph.D., and others in the Winter 2008 Simulation in Healthcare: Journal of the Society for Simulation in Health Care 3(4), pp. 209-216.

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