(1088) Multidisciplinary Code Simulation and Closed-Loop Communication Utilization

Introduction: Confident clinicians utilizing effective team communication are essential for successful resuscitation efforts in acutely decompensating critically ill patients. Simulation is an evidence-based training technique. The focus of this multidisciplinary simulation was to assess clinicians’ confidence in code events and to evaluate use of multi-disciplinary closed-loop communication before and after simulation training

Methods: Five simulation events were conducted over nine months in a surgical-trauma intensive care unit within an academic medical center. Participants were grouped based on clinical role (Group A: registered nurses, respiratory therapists, and nursing assistants; Group B: critical care attending physicians, critical care fellows, anesthesia/surgical residents, medical students, physician’s assistants/nurse practitioners). All participants completed a pre-survey. A brief presentation reviewed code supplies, roles, and closed-loop communication. Each simulation presented a unique emergency scenario leading to a code. Scenarios were run 1-2 times. After a structured debrief, a post-survey was conducted to evaluate changes in self-assessment of confidence and communication.

Results: Over the five simulations, 25 members of Group A and 21 members of Group B participated. Pre-survey data showed 80% of all respondents rated intra-disciplinary communication good or exceptional (Group A 72%; Group B: 90%). Post-survey data showed, 92% of all respondents rated intra-disciplinary communication good/exceptional after the simulation (Group A: 95%; Group B: 90%). Overall confidence in leading or assisting in a code among all respondents improved from 65% moderately or extremely confident pre-simulation to 92% post-simulation.

Conclusions: Implementation of a brief introduction, simulation, and debrief showed robust improvement in self-reported communication and confidence during code events among members of a multidisciplinary critical care team. These skills are essential to providing optimal care to critically ill patients. The importance of ongoing simulation cannot be overstated, and further studies on sustainability and cost effectiveness are needed.