Table 1.
Characteristics of Study Hospitals, Stratified by Resuscitation Champion Type at Hospitals
| Very Active MD Champion (n=29) | Very Active Non‐MD Champion (n=64) | No Champion or Not Active Champion (n=99) | P Value | |
|---|---|---|---|---|
| Hospital academic status | ||||
| Major teaching | 14 (56.0%) | 16 (28.1%) | 21 (26.9%) | |
| Minor teaching | 7 (28.0%) | 18 (31.6%) | 20 (25.6%) | |
| Nonteaching | 4 (16.0%) | 23 (40.4%) | 37 (47.4%) | |
| Missing | 4 | 7 | 21 | 0.03 |
| US census region | ||||
| Northeast and Mid‐Atlantic | 3 (12.0%) | 6 (10.5%) | 16 (20.3%) | |
| South Atlantic | 3 (12.0%) | 18 (31.6%) | 21 (26.6%) | |
| North Central | 6 (24.0%) | 13 (22.8%) | 19 (24.1%) | |
| South Central | 5 (20.0%) | 10 (17.5%) | 12 (15.2%) | |
| Mountain/Pacific | 8 (32.0%) | 10 (17.5%) | 11 (13.9%) | |
| Missing | 4 | 7 | 20 | 0.38 |
| No. IHCA events | ||||
| <150 | 9 (31.0%) | 22 (34.4%) | 36 (36.4%) | 0.54 |
| 150–250 | 5 (17.2%) | 10 (15.6%) | 24 (24.2%) | |
| >250 | 15 (51.7%) | 32 (50.0%) | 39 (39.4%) | |
| Code leader uses lanyards or hat | ||||
| Yes | 10 (34.5%) | 12 (18.8%) | 8 (8.1%) | |
| No | 19 (65.5%) | 52 (81.3%) | 91 (91.9%) | 0.002 |
| Who typically leads codes | ||||
| Attending‐level physicians | 15 (51.7%) | 42 (65.6%) | 63 (63.6%) | |
| Critical care nurses | 0 (0.0%) | 4 (6.3%) | 7 (7.1%) | |
| Nurse‐practitioner or nurse | 0 (0.0%) | 0 (0.0%) | 1 (1.0%) | |
| Physician trainees—residents | 10 (34.5%) | 13 (20.3%) | 22 (22.2%) | |
| Physician trainees—fellows | 4 (13.8%) | 3 (4.7%) | 6 (6.1%) | |
| Other | 0 (0.0%) | 2 (3.1%) | 0 (0.0%) | 0.39 |
| Code team members communicate well during resuscitations | ||||
| Always (80%–100%) | 13 (44.8%) | 18 (28.1%) | 21 (21.2%) | |
| Most of the time (60%–80%) | 8 (27.6%) | 41 (64.1%) | 58 (58.6%) | |
| About half the time (40%–60%) | 6 (20.7%) | 5 (7.8%) | 16 (16.2%) | |
| Sometimes (20%–40%) | 2 (6.9%) | 0 (0.0%) | 4 (4.0%) | 0.005 |
| Code team members comfortable making their voices during resuscitations | ||||
| Always (80%–100%) | 8 (27.6%) | 19 (29.7%) | 30 (30.3%) | |
| Most of the time (60%–80%) | 13 (44.8%) | 37 (57.8%) | 51 (51.5%) | |
| About half the time (40%–60%) | 8 (27.6%) | 6 (9.4%) | 10 (10.1%) | |
| Sometimes (20%–40%) | 0 (0.0%) | 1 (1.6%) | 7 (7.1%) | |
| Never or rarely (0%–20%) | 0 (0.0%) | 1 (1.6%) | 1 (1.0%) | 0.22 |
| Devices used to assist in resuscitation | ||||
| CPR process measure device | 11 (37.9%) | 18 (28.1%) | 24 (24.2%) | 0.35 |
| Capnography | 18 (62.1%) | 45 (70.3%) | 54 (54.5%) | 0.13 |
| Mechanical CPR device | 4 (13.8%) | 3 (4.7%) | 8 (8.1%) | 0.34 |
| Monitoring of diastolic pressures | 7 (24.1%) | 8 (12.5%) | 7 (7.1%) | 0.046 |
| Number of devices routinely used | ||||
| 1 | 15 (51.7%) | 31 (48.4%) | 63 (63.6%) | |
| 2 | 9 (31.0%) | 28 (43.8%) | 29 (29.3%) | |
| 3 | 5 (17.2%) | 5 (7.8%) | 7 (7.1%) | 0.15 |
| Staff member usually assigned performing chest compressions | ||||
| No staff member usually assigned | 13 (44.8%) | 37 (57.8%) | 55 (55.6%) | |
| Critical care nurses | 1 (3.4%) | 3 (4.7%) | 7 (7.1%) | |
| Medical‐surgical floor nurses | 1 (3.4%) | 9 (14.1%) | 12 (12.1%) | |
| Physician trainees | 3 (10.3%) | 4 (6.3%) | 4 (4.0%) | |
| Nursing student or paramedic | 1 (3.4%) | 0 (0.0%) | 1 (1.0%) | |
| Respiratory therapist | 6 (20.7%) | 7 (10.9%) | 6 (6.1%) | |
| Clinical technician | 2 (6.9%) | 3 (4.7%) | 14 (14.1%) | |
| Other | 2 (6.9%) | 1 (1.6%) | 0 (0.0%) | 0.04 |
| An individual outside of leader monitors CPR quality | ||||
| Yes | 7 (24.1%) | 18 (28.1%) | 15 (15.2%) | |
| No | 22 (75.9%) | 46 (71.9%) | 84 (84.8%) | 0.12 |
| Code debriefing performed immediately | ||||
| Always or almost always (80%–100%) | 5 (17.2%) | 6 (9.4%) | 16 (16.2%) | |
| Frequently (60%–80%) | 7 (24.1%) | 15 (23.4%) | 9 (9.1%) | |
| Occasionally (20%–60%) | 6 (20.7%) | 21 (32.8%) | 24 (24.2%) | |
| Rarely (1%–20%) | 11 (37.9%) | 17 (26.6%) | 34 (34.3%) | |
| Never (0%) | 0 (0.0%) | 5 (7.8%) | 16 (16.2%) | 0.03 |
| Nursing staff can use manual defibrillator | 5 (17.2%) | 14 (21.9%) | 29 (29.3%) | 0.33 |
| Mock codes | ||||
| Yes | 25 (86.2%) | 56 (87.5%) | 85 (85.9%) | |
| No | 4 (13.8%) | 8 (12.5%) | 14 (14.1%) | 0.96 |
| Frequency of mock codes | ||||
| Not done | 4 (13.8%) | 8 (12.5%) | 14 (14.1%) | 0.34 |
| Less than once quarterly | 13 (44.8%) | 38 (59.4%) | 63 (63.6%) | |
| At least quarterly | 12 (41.4%) | 18 (28.1%) | 22 (22.2%) | |
| Barriers to resuscitation care | ||||
| Lack of direct feedback | ||||
| Yes | 12 (41.4%) | 24 (37.5%) | 63 (63.6%) | |
| No | 17 (58.6%) | 40 (62.5%) | 36 (36.4%) | 0.002 |
| Inadequate training | ||||
| Yes | 5 (17.2%) | 12 (18.8%) | 28 (28.3%) | |
| No | 24 (82.8%) | 52 (81.3%) | 71 (71.7%) | 0.26 |
| Lack of support from administration | ||||
| Yes | 3 (10.3%) | 5 (7.9%) | 17 (17.3%) | |
| No | 26 (89.7%) | 58 (92.1%) | 81 (82.7%) | |
| Missing | 0 | 1 | 1 | 0.23 |
| Lack of financial resources | ||||
| Yes | 10 (34.5%) | 13 (20.6%) | 25 (25.3%) | |
| No | 19 (65.5%) | 50 (79.4%) | 74 (74.7%) | |
| Missing | 0 | 1 | 0 | 0.36 |
| Are cardiac arrest data routinely reviewed | ||||
| Yes | 29 (100.0%) | 61 (95.3%) | 88 (88.9%) | |
| No | 0 (0.0%) | 3 (4.7%) | 11 (11.1%) | 0.09 |
| Rank the purpose of routine cardiac arrest data review | ||||
| Review IHCA metrics | ||||
| Strongly agree | 25 (86.2%) | 49 (76.6%) | 63 (63.6%) | |
| Somewhat agree | 4 (13.8%) | 10 (15.6%) | 20 (20.2%) | |
| Neither agree nor disagree | 0 (0.0%) | 2 (3.1%) | 3 (3.0%) | |
| Strongly disagree | 0 (0.0%) | 0 (0.0%) | 3 (3.0%) | |
| No routine data review | 0 (0.0%) | 3 (4.7%) | 10 (10.1%) | 0.34 |
| Identify areas for improvement | ||||
| Strongly agree | 23 (79.3%) | 48 (75.0%) | 55 (55.6%) | |
| Somewhat agree | 5 (17.2%) | 11 (17.2%) | 22 (22.2%) | |
| Neither agree nor disagree | 1 (3.4%) | 2 (3.1%) | 6 (6.1%) | |
| Somewhat disagree | 0 (0.0%) | 0 (0.0%) | 3 (3.0%) | |
| Strongly disagree | 0 (0.0%) | 0 (0.0%) | 3 (3.0%) | |
| No routine data review | 0 (0.0%) | 3 (4.7%) | 10 (10.1%) | 0.25 |
| Identify errors in resuscitation Care | ||||
| Strongly agree | 20 (69.0%) | 43 (67.2%) | 42 (42.4%) | |
| Somewhat agree | 7 (24.1%) | 14 (21.9%) | 26 (26.3%) | |
| Neither agree nor disagree | 1 (3.4%) | 2 (3.1%) | 11 (11.1%) | |
| Somewhat disagree | 1 (3.4%) | 1 (1.6%) | 6 (6.1%) | |
| Strongly disagree | 0 (0.0%) | 1 (1.6%) | 4 (4.0%) | |
| No routine data review | 0 (0.0%) | 3 (4.7%) | 10 (10.1%) | 0.059 |
| Track success of QI initiative | ||||
| Strongly agree | 20 (69.0%) | 41 (64.1%) | 46 (46.9%) | |
| Somewhat agree | 5 (17.2%) | 15 (23.4%) | 20 (20.4%) | |
| Neither agree nor disagree | 3 (10.3%) | 5 (7.8%) | 16 (16.3%) | |
| Somewhat disagree | 1 (3.4%) | 0 (0.0%) | 3 (3.1%) | |
| Strongly disagree | 0 (0.0%) | 0 (0.0%) | 3 (3.1%) | |
| No routine data review | 0 (0.0%) | 3 (4.7%) | 10 (10.2%) | |
| Missing | 0 | 0 | 1 | 0.14 |
IHCA indicates in‐hospital cardiac arrest; MD, physician; and QI, quality improvement.