Abstract：
UNASSIGNED: After identifying chest compression fraction (CCF) as a key area for improvement, our Emergency Medical Services (EMS) agency aimed to improve our baseline monthly median CCF from 81.5% to 90% or more in paramedic-attended medical cardiac arrests by December 2023. The CCF is a process measure that, if improved, has been shown to increase likelihood of survival from cardiac arrest. Working as a hospital EMS agency within a large urban 9-1-1 system, our interventions focused on paramedics once they arrived on scene.
UNASSIGNED: This project used repeated Plan-Do-Study-Act (PDSA) cycles with brainstorming sessions, focus groups, and data review to achieve improvement. Interventions included standardized clinician feedback forms, increased follow-up for patients with ongoing resuscitation, a designated CPR team leader during resuscitations, and a pre-charged defibrillator prior to rhythm checks. These interventions were evaluated by tabulating weekly and monthly median CCF performance, seeking participant feedback, and reviewing control charts. These results were reported according to the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0).
UNASSIGNED: Our control chart analysis revealed special cause variation and an increase in average CCF to 89.0%. This improvement was achieved through successful implementation of process changes using PDSA cycles. Our most effective and popular intervention was our clinician feedback forms. Additionally, re-unifying patients and their successful resuscitation teams, participating in resuscitation academy events, and pre-charging the defibrillator to minimize CPR pauses collectively resulted in systemic improvement in resuscitation performance.
UNASSIGNED: The findings illustrate that targeted education, increased clinician feedback, patient-team reunification, and high-performance resuscitation strategies produce measurable improvement in CCF.
UNASSIGNED: This project used repeated Plan-Do-Study-Act (PDSA) cycles with brainstorming sessions, focus groups, and data review to achieve improvement. Interventions included standardized clinician feedback forms, increased follow-up for patients with ongoing resuscitation, a designated CPR team leader during resuscitations, and a pre-charged defibrillator prior to rhythm checks. These interventions were evaluated by tabulating weekly and monthly median CCF performance, seeking participant feedback, and reviewing control charts. These results were reported according to the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0).
UNASSIGNED: Our control chart analysis revealed special cause variation and an increase in average CCF to 89.0%. This improvement was achieved through successful implementation of process changes using PDSA cycles. Our most effective and popular intervention was our clinician feedback forms. Additionally, re-unifying patients and their successful resuscitation teams, participating in resuscitation academy events, and pre-charging the defibrillator to minimize CPR pauses collectively resulted in systemic improvement in resuscitation performance.
UNASSIGNED: The findings illustrate that targeted education, increased clinician feedback, patient-team reunification, and high-performance resuscitation strategies produce measurable improvement in CCF.
摘要：
■在将胸部按压分数（CCF）确定为需要改进的关键领域之后，我们的紧急医疗服务(EMS)机构的目标是在2023年12月之前将护理人员参与的医疗心脏骤停的基线每月中位CCF从81.5%提高到90%或更高.CCF是一种过程措施，如果改进，已被证明可以增加从心脏骤停中存活的可能性。在大型城市9-1-1系统中担任医院EMS机构，一旦护理人员到达现场，我们的干预措施就集中在他们身上。
■该项目使用了反复的计划-做-研究-行动（PDSA）循环和头脑风暴会议，焦点小组,和数据审查，以实现改进。干预措施：干预措施包括标准化的临床医生反馈表格，增加对正在进行复苏的患者的随访，复苏期间指定的心肺复苏小组组长，和在心律检查前的预充电除颤器。这些干预措施是通过每周和每月的中位CCF表现来评估的，寻求参与者的反馈，并查看控制图。这些结果是根据经修订的卓越质量改进报告标准（SQUIRE2.0）报告的。
■我们的控制图分析揭示了特殊原因变化和平均CCF增加到89.0%。这种改进是通过使用PDSA循环成功实施工艺改变来实现的。我们最有效和最受欢迎的干预措施是我们的临床医生反馈表格。此外,重新统一患者及其成功的复苏团队，参加复苏学院的活动，并对除颤器进行预充电以最大程度地减少CPR暂停，这共同导致了复苏性能的系统性改善。
■研究结果表明，有针对性的教育，增加临床医生的反馈，患者团队统一，和高性能的复苏策略可以在CCF中产生可测量的改善。
■该项目使用了反复的计划-做-研究-行动（PDSA）循环和头脑风暴会议，焦点小组,和数据审查，以实现改进。干预措施：干预措施包括标准化的临床医生反馈表格，增加对正在进行复苏的患者的随访，复苏期间指定的心肺复苏小组组长，和在心律检查前的预充电除颤器。这些干预措施是通过每周和每月的中位CCF表现来评估的，寻求参与者的反馈，并查看控制图。这些结果是根据经修订的卓越质量改进报告标准（SQUIRE2.0）报告的。
■我们的控制图分析揭示了特殊原因变化和平均CCF增加到89.0%。这种改进是通过使用PDSA循环成功实施工艺改变来实现的。我们最有效和最受欢迎的干预措施是我们的临床医生反馈表格。此外,重新统一患者及其成功的复苏团队，参加复苏学院的活动，并对除颤器进行预充电以最大程度地减少CPR暂停，这共同导致了复苏性能的系统性改善。
■研究结果表明，有针对性的教育，增加临床医生的反馈，患者团队统一，和高性能的复苏策略可以在CCF中产生可测量的改善。
