Get With The Guidelines-Resuscitation
Gold Recognition Award Application
IMPROVEMENT IN THE TREATMENT OF CARDIOPULMONARY ARREST
BY IMPLEMENTATION OF GET WITH THE GUIDELINES AT
______________________________________________________________________________________________________
(Hospital Name as it is to appear on the certificate)
_______________________________________________________________________________________________________
Full Address (Street, City, State)
______________________________________________________________________________________________________
(Author(s)--please list first and last names and credentials)
Please indicate which patient populations you are submitting the GWTG-Resuscitation award for (check all that apply):
Adult
Pediatric
Newborn/Neonates
Background: Get With The Guidelines®-Resuscitation is the American Heart Association’s collaborative quality improvement
program, demonstrated to improve adherence to evidence-based care of patients who experience an in-hospital resuscitation
event. The primary goal is to help hospital teams save more lives threatened by cardiopulmonary emergencies through
consistent application of the most up-to-date scientific guidelines for in-hospital resuscitation.
Method: Baseline date is ____________________ (mm/dd/yyyy) as defined on the Community Page of the PMT
January 2013
Quality Improvement Strategies:
1. What disciplines are represented in your hospitals multidisciplinary Cardiac Arrest team? [Check all that apply for the team that responds to the patient
population that is applicable]
___We Do Not Have a Multidisciplinary Team
___Attending or Staff Physician
___ Interns/Residents
___Respiratory Care
___Nurse Manager
___Nurse Supervisor
___Pharmacist
___Critical Care Nurse
___Emergency Room Nurse
2. Is it standard for your hospital to have an identified Code Team Leader for each event?
3. Is Advanced Life Support training required for Cardiac Arrest Team members?
Physicians
___Y ___N ___ Unknown
Nurses
___Y ___N ___ Unknown
4. Are Cardiac Arrest Team debriefings or reviews routinely conducted?
___Y ___N ___ Unknown
5. Do the members of your multidisciplinary team have FTE Support specifically for QI Activities?
6. Is specific feedback on measure adherence provided to physicians?
___Y ___N ___ Unknown
___Yes as a group ___Yes individually ___No
7. Is there a system in place to provide feedback to the members of the Cardiac Arrest Team?
____Y ____N ______Unknown
8. How often are GWTG reports shared with the Housewide Resuscitation Committee?
___weekly ___monthly ___quarterly ___biannual ___annually ___other
9. What QI processes or interventions were critical to your ability to achieve or sustain this award level of adherence?
January 2013
2
Our hospital is entering data (in the PMT): Please check all that apply:
___ Concurrently
___ Retrospectively (after patient is discharged)
___ Via uploads
Total number of hospital discharges
Please identify number of patients discharged from the hospital for the reporting period
Year 1
Year 2
Year 1
Year 2
Year 1
Year 2
Adult
01/01/yyyy
–
12/31/yyyy
Adult
01/01/yyyy
–
12/31/yyyy
Pediatric
01/01/yyyy
–
12/31/yyyy
Pediatric
01/01/yyyy
–
12/31/yyyy
Newborn/
Neonate
01/01/yyyy
12/31/yyyy
Newborn/
Neonate
01/01/yyyy
–
12/31/yyyy
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–
Number of patients with CPA events entered into the PMT during this
post-intervention period.
For low volume hospitals, 30 patient minimum per reporting period or the equivalent of
12 months of patients are required. Please identify number of patients for the reporting
period.
January 2013
3
Results: Implementation of GWTG-Resuscitation showed compliance with the below measures.
You must provide the numerator (N) and denominator (D) as well as percentage each measure under the patient populations (Adult, Pediatric and/or
Newborn/Neonate) as indicated above.
The percentage must be at a minimum of 85% each of the four measures. Percentages may be rounded up to the first decimal (84.6%) as this
conforms to PMT percentage reporting.
Adult Achievement Measures
For All Cardiac Arrest Patients
Percent of events in adult patients who were monitored or
witnessed at the time of arrest.
Percentage of time to first chest compressions <= 1 min in
adult patients
Percent of adult events with an endotracheal tube placement
which was confirmed to be correct.
Percent of events in adult patients with VF/pulseless VT as
first documented rhythm in whom time to first shock <= 2
minutes of event recognition.
Newborn/Neonate Achievement Measures
For All Cardiac Arrest Patients
Percentage of time to first chest compressions <= 1 min in
newborn/neonates >= 10 min old:
Percentage of time to first chest compressions <= 2 min for
newborn/neonates < 10 min old
Percentage of time to invasive airway <= 2 min in
newborn/neonates from onset of cardiac event
Percent of newborn/neonatal events with an endotracheal
tube placement which was confirmed to be correct
January 2013
Postintervention
Year 1
Postintervention
Year 2
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
Postintervention
Year 1
Postintervention
Year 2
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
Pediatric Achievement Measures
For All Cardiac Arrest Patients
Percent of events in pediatric patients
who were monitored or witnessed at the
time of arrest.
Percentage of time to first chest
compressions <= 1 min in pediatric
patients
Percent of pediatric events with an
endotracheal tube placement which was
confirmed to be correct.
Percent of events in pediatric patients with
VF/pulseless VT as first documented
rhythm in whom time to first shock <= 2
minutes of event recognition.
Postintervention
Year 1
Postintervention
Year 2
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
4