Post Arrest Consult Team: a knowledge translation strategy for post-cardiac arrest care

Brooks, SC; Scales, Damon C.; Dainty, KN; Gray, Sara; Pinto, Ruxandra; Racz, Elizabeth; Gaudio, Michelle; Amaral, Andre C.; Baker, Andrew J.; Chapman, Martin; Crystal, Eugene; Dorian, Paul; Fam, Neil; Fowler, Robert; Friedrich, Jan O.; Madan, Mina; Rubenfeld, Gordon D.; Smith, Orla M.; Morrison, LJ

doi:10.1186/cc13682

Cited by 1 publication

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“…While purposefully designed as a multi-method study from the outset, largely negative quantitative study results have turned greater attention to understanding what contextual factors may have influenced the results of the intervention. The quantitative concurrent control study was able to demonstrate that a specialized post-cardiac arrest consult team was able to impact the occurrence of premature withdrawal of life-sustaining therapy but did not improve rates of targeted temperature management, the use of coronary angiography, or electrophysiology assessments prior to hospital discharge [ 14 ]. The analysis and observations reported here reveal three key findings that may have had a fundamental impact on the PACT’s ability to function as intended and to influence the uptake of most of the evidence-based guidelines.…”

Section: Discussionmentioning

confidence: 99%

“…With this in mind, the intervention was designed to directly address barriers to optimal care for post-cardiac arrest patients by implementing a specialized Post Arrest Consult Team (PACT) at two urban academic centers. The primary analysis of this intervention, which is published elsewhere [ 14 ], involved a quantitative comparison of process and clinical outcomes with concurrent and historical controls from several other hospitals that did not have PACT implementation within the same geographical region.…”

Section: Introductionmentioning

confidence: 99%

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Implementation of a post-arrest care team: understanding the nuances of a team-based intervention

Dainty¹,

Racz²,

Morrison³

et al. 2015

Implementation Sci

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BackgroundDespite advances in the management of sudden cardiac arrest, mortality for patients admitted to hospital is still greater than 50 %. Lack of familiarity and experience with post-cardiac arrest patients and lack of interdisciplinary collaboration between emergency and ICU staff have been highlighted as potential barriers to optimal care. To address these barriers, a specialized Post Arrest Consult Team (PACT) was implemented at two urban academic centers.Our objective was to describe the PACT implementation from the participant perspective in order to explore potentially mitigating factors on effectiveness of the intervention and inform other institutions who may be considering a similar approach.MethodsUsing an ethnographic style approach, we collected data throughout the implementation period using both key informant interviews and non-participant observation. The data were analyzed using interpretive descriptive analysis techniques.ResultsThe PACT intervention was taken up differently in each of the two participating institutions. Participants spoke about the difficulty in maintaining a dynamic interaction between the team members and a shared sense of purpose, the challenge of off-service consulting and the impact of the lack of data feedback to support whether the project was effecting change.ConclusionsIt appears that purposefully creating a “sense of team,” the team composition and organizational culture and provision of performance feedback are important facilitators to ensuring uptake of a team-based intervention like the PACT model. Reporting of the intervention design and actual implementation experience like we have done here is crucial to allow readers to judge the quality of the study, to properly replicate it, and to contemplate how various factors may influence the outcome of a complex intervention.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%