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Improving Quality Improvement for Cardiopulmonary Resuscitation

Jeffrey T. Berger, MD1,2
[+] Author Affiliations
1Stony Brook University School of Medicine, Stony Brook, New York
2Winthrop University Hospital, Mineola, New York
JAMA Intern Med. 2013;173(20):1859-1860. doi:10.1001/jamainternmed.2013.10034.
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Continuous quality improvement seeks to improve the delivery of clinical care by collecting and analyzing data, measuring outcomes, and providing feedback.1 In hospitals, continuous quality improvement processes are widely used to monitor and improve the use of invasive interventions including cardiopulmonary resuscitation (CPR). At present, such committees tend to focus on the procedural aspects of CPR, such as time to first defibrillation, and whether the selection of medications and their sequential administration were appropriate for the corresponding rhythm disturbances. Committees do not regularly scrutinize CPR attempts for appropriate clinical indications. This approach differs from continuous quality improvement activities for other invasive procedures, such as bronchoscopy and coronary angiography. This difference in approaches is particularly striking, given the high morbidity and mortality associated with CPR.2 Why is CPR assessed with less rigor?

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