Umesh Dyamenahalli
University of Chicago Medicine, USA
Title: Expansion of Medical Excellence Processes in Cardiac Intensive Care Unit: Routine bedside debriefing followed by Comprehensive Root Cause Analysis after CPR.
Biography
Biography: Umesh Dyamenahalli
Abstract
Learning Objectives: Multidisciplinary post-CPR debriefing enhances problem understanding and team empowerment. A comprehensive Root-Cause-Analysis of CPR event enhances quality of care.
Introduction/Background: Advanced diagnostic and therapeutic modalities have improved survival and outcomes in cardiac ICU. In a complex medical environment, timely recognition and understanding pathogenesis of complications is paramount, which is achievable through debriefing and root-cause-analysis.
Initiative Description: Two initiatives are based on existing ideas and were integrated into routine practice to enhance the understanding of the problems using multidisciplinary approaches.
Innovation: Routine debriefing after CPR, in a complex ICU environment, have not been described. In-depth and routine, medical team initiated RCA after CPR has not been widely practiced and publicized.
Results/Outcomes: Since 2008, debriefings have been performed utilizing continuous PDSA cycles. This modified the management, resulted in comprehensive training initiatives, system improvement and creation of protocols. It impacted patient care and safety culture positively and empowers the staff. Since 2007 RCA after CPR events performed. In about 50% events, review suggested areas for improvement in management.
Lessons Learned: Clinical debriefing in CICUs is feasible, positively impacts quality of patient care, enhances safety culture, improves occurrence reporting and empowers staff. Routine Post-CPR, RCA is feasible in a busy CICU. In complex patients, these reviews serve as a model tool to enhance patient care, team education and avert some CPR event.