• Dana P Edelson, Trevor C Yuen, Mary E Mancini, Daniel P Davis, Elizabeth A Hunt, Joseph A Miller, and Benjamin S Abella.
• Department of Medicine, University of Chicago, Chicago, Illinois.
• J Hosp Med. 2014 Jun 1;9(6):353-7.

BackgroundIn-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals.ObjectiveTo describe current US hospital practices with regard to resuscitation care.DesignA nationally representative mail survey.SettingA random sample of 1000 hospitals from the American Hospital Association database, stratified into 9 categories by hospital volume tertile and teaching status (major teaching, minor teaching, and nonteaching).SubjectsSurveys were addressed to each hospital's cardiopulmonary resuscitation (CPR) committee chair or chief medical/quality officer.MeasurementsA 27-item questionnaire.ResultsResponses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (P = 0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a hospitalist. High frequency practices included having a rapid response team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least 1 barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common.ConclusionsThere is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.© 2014 Society of Hospital Medicine.

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