Get With The Guidelines-Resuscitation
Silver 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
October 2011
RD 04-2012
RD 07-2012
1
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?
RD 07-2012
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
Adult
mm/dd/yyyy –
mm/dd/yyyy
Pediatric
mm/dd/yyyy –
mm/dd/yyyy
Newborn/Neonate
mm/dd/yyyy –
mm/dd/yyyy
>number<
>number<
>number<
>number<
>number<
>number<
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.
RD 07-2012
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
RD 07-2012
Postintervention
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
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
Postintervention
N/D (x %)
N/D (x %)
N/D (x %)
N/D (x %)
4