A paradigm shift in resuscitation training
The challenge
3X difference in survival
In the US, around 300,000 in-hospital cardiac arrests occur annually. Only 1 in 4 patients survive, with rates ranging from under 10% to nearly 40% across hospitals.
Analysis of these data revealed three key resuscitation practices linked to higher survival rates: frequent case reviews, continuous chest compression monitoring, and staff evaluations of resuscitation training effectiveness.
Standardizing CPR quality across hospitals could help save approximately 50,000 additional lives annually in the US.
THE OPPORTUNITY
Competency-based education
Research in the early 2010s showed that CPR skills often deteriorate within three to six months, making two-year refresher intervals inadequate.
Instead, allowing healthcare professionals to refresh skills in short, quarterly sessions at a skill testing session at their workplace was shown to be effective in counteracting skill decay and greatly improved skill performance over time.
This model also reduced training costs and provided greater convenience for both the hospital and healthcare providers by eliminating the need for off-site courses and offering flexible scheduling. But most importantly, quality of care improved. At one of the early adopters of this methodology - Texas Health Presbyterian Hospital in Dallas - survival doubled in the first year.
the program
Low-dose, high-frequency training
The significant lifesaving potential motivated the American Heart Association® (AHA) and Laerdal to form a partnership in 2018; RQI Partners, to help accelerate Resuscitation Quality Improvement® (RQI®) program adoption by hospitals and health systems.
The RQI program follows a low-dose, high-frequency model offering quarterly CPR skills refreshers. The program provides mastery learning via deliberate practice, implemented through quality improvement sessions that measure and verify competence.
The cognitive part of RQI uses the AHA-Laerdal HeartCode® program’s e-learning component, which breaks down the curriculum into bite-size learning activities each quarter.
In place of the two-year “course completion card.” the program has taken a big step forward by issuing an “e-Credential,” which verifies the learner is competent in resuscitation skills.
Building upon our decades-long alliance and collaborative suite of products, the American Heart Association and Laerdal Medical introduced Resuscitation Quality Improvement in 2015. This innovative digital program is setting a new global standard in CPR training and can help save many more lives from cardiac arrest.
- Nancy Brown, CEO, The American Heart Association
THE IMPACT
Going to scale in US and growing internationally
A study directly comparing instructor-led training with the RQI program showed that providers recently trained in BLS with an instructor were unable to meet the AHA’s guidelines for correct compressions and ventilation when measured objectively at an RQI Simulation Station. After one RQI session, overall compression scores increased by 81% and ventilation scores grew from 19% to 70%.
Our digital resuscitation programs, including RQI, are now used by more than 3 million healthcare professionals globally with an estimated more than 20,000 extra lives having been saved over the last three years based on the experience of early adopters.
Expanding into new programs
RQI for newborn resuscitation
In 2021, the American Academy of Pediatrics’ Neonatal Resuscitation Program® (NRP®) combined with the Resuscitation Quality Improvement program to create RQI for NRP — a new and innovative quality improvement solution.
Quarterly, self-directed instruction and skills and knowledge assessments lead to mastery, maintenance and verified competence on a neonatal simulator for the single most, impactful intervention for newborns needing resuscitation: positive pressure ventilation.
RQI for nurse education
In 2021, Laerdal's and its longstanding strategic partner, the National League for Nursing, collaborated to bring the RQI program to US nursing schools.
Nearly 40 nursing programs at US colleges and universities have adopted RQI, becoming the first higher education institutions to introduce true competency-based education for resuscitation. It is estimated that more than 150,000 students graduate from nursing programs at U.S. colleges and universities annually. Upon graduation, these students will make a significant impact on the health outcomes of their patients and the healthcare systems and communities they serve.
A long-standing partnership
Laerdal and the American Heart Association (AHA) have worked together for close to 50 years.
It was in 1974 that Laerdal supported the publication and distribution of the AHA’s first “Standards and Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiac Care.” In 1997, a vital alliance was formed between the two organizations leading to the development of the HeartCode e-learning program and the Mini Anne kit for CPR training in schools and the community. In 2014 they introduced together the Resuscitation Quality Improvement (RQI) program to US hospitals. This program was based around the so-called Low-Dose, High-Frequency (LDHF) principle, moving health care away from big dose, infrequent training to focusing on continuous improvement of competence.
