Amber Rice

Amber Rice, MD, MS
arice@aemrc.arizona.edu

University of Arizona
COM
Department of Emergency Medicine

Title: Improvement in team dynamics and CPR quality in simulated code scenarios after High Performance Team Based Training intervention including audiovisual feedback.

Cardiopulmonary resuscitation (CPR) quality is associated with improved survival from out of hospital cardiac arrest (OHCA).  Most hospital-based providers (including medical residents) receive some form of basic or advanced cardiac life support training that does not specifically focus on team dynamics or the use of audiovisual feedback, which has been shown beneficial in the pre-hospital setting.  Pre-hospital training emphasizing a teamwork and specific training to minimize compression interruptions (also known as pit crew CPR) is associated with improved CPR quality as well as improved survival to hospital discharge. The primary focus of the proposed project is to assess whether these educational training techniques are beneficial to hospital-based providers, who generally work in ever changing teams.  

The hypothesis was that “High Performance CPR” training intervention including audiovisual feedback will lead to improved team dynamics in simulated code scenarios with medical residents. 

Data Analysis:

We used a validated team checklist to evaluate each team during the pre-intervention and post-intervention mock code scenarios (attached, spreadsheet and team checklist)

  • First question is whether to analyze individual checklist items separately or to combine into the different domains tested

We abstracted accelerometer data to evaluate CPR quality in pre and post groups. (Attached spreadsheet, highlighted in orange is American Heart Association Recommended parameters with which we compared performance)

  • Are there other recommended statistical analysis that could be performed, or should it remain as more of a case series type presentation (see graphs)?

Rice CPRU Master Data

Rice TEAM Validity Testing Article

Rice TEAM Development Article

 

Initial Meeting

I.  Who:

Client: Amber Rice MD, MS (COM Department of Emergency Medicine – University of Arizona)

Consultants: Dean Billheimer, Chen Chen, Shahin Mohammadi, Mirjana Glisovic-Bensa (author)

II.  When:

26 September 2019, 1-2pm

III.  What:

  1. Summary of Client’s Problem

Cardiopulmonary resuscitation (CPR) quality is associated with improved survival from out of hospital cardiac arrest (OHCA).  Most hospital-based providers (including medical residents) receive some form of basic or advanced cardiac life support training that does not specifically focus on team dynamics or the use of audiovisual feedback, which has been shown beneficial in the pre-hospital setting.  Pre-hospital training emphasizing a teamwork and specific training to minimize compression interruptions (also known as pit crew CPR) is associated with improved CPR quality as well as improved survival to hospital discharge. The primary focus of the proposed project is to assess whether these educational training techniques are beneficial to hospital-based providers.

The hypothesis was that “High Performance CPR” training intervention including audiovisual feedback will lead to improved team dynamics in simulated code scenarios with medical residents. 

 

B.  Discussion 

Amber explained in detail that this was pilot study of only 5 groups. Her interest is to see if implementing these educational training techniques can be implemented as mandatory for hospital-based providers. Amber mentioned that identifying in hospital cardiac arrest is hard.

IV.  Next Steps

We suggested the following:

-We will do comparison test to see if there is a difference in  leadership, team work and overall before and after implementing training trainig.