Training the Code Team Leader as a Forcing Function to Improve Overall Team Performance During Simulated Code Blue Events

The American Heart Association (AHA) estimates that there are approximately 200,000 in-hospital cardiac arrests (IHCA) annually with low rates of survival to discharge at about 22%. Training programs for cardiac arrest teams, also termed code teams, have been recommended by the Institute of Medicine (IOM) and in the AHA's consensus statement to help improve these dismal survival rates. Historically, training programs in the medical field are procedural in nature and done at the individual level, despite the fact that healthcare providers frequently work in teams. The rigidity of procedural training can cause habituation and lead to poor team performance if the situation does not match the original training circumstances. Despite the need for team training, factors such as logistics, time, personnel coordination, and financial constraints often hinder resuscitation team training. This research was a three-step process of: 1) development of a metric specific for the evaluation of code team performance, 2) development of a communication model that targeted communication and leadership during a code blue resuscitation, and 3) training and evaluation of the code team leader using the communication model. This research forms a basis to accomplish a broad vision of improving outcomes of IHCA events by applying conceptual and methodological strategies learned from collaborative and inter-disciplinary science of teams.