Hospital cardiac arrest resuscitation practice in the United States: a nationally representative survey

J Hosp Med. 2014 Jun;9(6):353-7. doi: 10.1002/jhm.2174. Epub 2014 Feb 19.


Background: In-hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in practice as a potential etiology. However, little is known about the standards of IHCA resuscitation practice among US hospitals.

Objective: To describe current US hospital practices with regard to resuscitation care.

Design: A nationally representative mail survey.

Setting: A random sample of 1000 hospitals from the American Hospital Association database, stratified into 9 categories by hospital volume tertile and teaching status (major teaching, minor teaching, and nonteaching).

Subjects: Surveys were addressed to each hospital's cardiopulmonary resuscitation (CPR) committee chair or chief medical/quality officer.

Measurements: A 27-item questionnaire.

Results: Responses were received from 439 hospitals with a similar distribution of admission volume and teaching status as the sample population (P = 0.50). Of the 270 (66%) hospitals with a CPR committee, 23 (10%) were chaired by a hospitalist. High frequency practices included having a rapid response team (91%) and standardizing defibrillators (88%). Low frequency practices included therapeutic hypothermia and use of CPR assist technology. Other practices such as debriefing (34%) and simulation training (62%) were more variable and correlated with the presence of a CPR committee and/or dedicated personnel for resuscitation quality improvement. The majority of hospitals (79%) reported at least 1 barrier to quality improvement, of which the lack of a resuscitation champion and inadequate training were the most common.

Conclusions: There is wide variability among hospitals and within practices for resuscitation care in the United States with opportunities for improvement.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Cardiopulmonary Resuscitation / methods*
  • Cardiopulmonary Resuscitation / trends
  • Data Collection / methods*
  • Heart Arrest / diagnosis
  • Heart Arrest / epidemiology*
  • Heart Arrest / therapy*
  • Hospitalization* / trends
  • Hospitals* / trends
  • Humans
  • United States / epidemiology