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HEROIC is attempting to identify best practices for In-Hospital Cardiac Arrest (IHCA) utilized by hospitals with high performance in resuscitation care. It involves U.S. hospitals participating in the AHA’s national Get With The Guidelines (GWTG)-Resuscitation registry.

HEROIC identified 4 core elements of resuscitation teams at high performing hospitals linked to better outcomes:

1) Team Design
designated teams

Employ dedicated or designated resuscitation teams that are not created ad-hoc

respond immed

Respond immediately to an IHCA with a plan in place to cover clinical responsibilities

2) Team Composition & Roles

Create multidisciplinary teams for IHCA response which include physician, nursing, RT, and pharmacy involvement.


Avoid overcrowding and have clearly defined roles and responsibilities during a resuscitation, including team leader, chest compressions, airway management, IV access and documentation

3) Communication & Leadership
mutual respect

Encourage mutual respect among team members


Identify a code leader early on and facilitate closed-loop communication during resuscitation

4) Training & Education
patient on stretcher

Conduct multidisciplinary mock codes that are regular and unscheduled, occur in patient rooms and high-risk areas, and include post-mock code debriefing


Emphasize both ACLS content and teamwork

Additional work is being performed to validate these findings in a larger cohort of hospitals. However, these early results may assist individual hospitals in examining their own care practices for IHCA and provide specific, actionable recommendations to improve management of these high-risk patients.

HEROIC is an NHLBI-funded, mixed-methods study conducted in partnership with the American Heart Association (AHA) and a collaboration between the Mid-America Heart Institute and the University of Michigan

For more information, please contact Brad Trumpower, trumpb@med.umich.edu