QI forum By Hope Racine The benefi ts of IR code simulation


This column highlights various quality improvement projects that were presented during the 2nd Annual Quality Improvement Forum at the 2025 Annual Scientifi c Meeting in Nashville.


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nterventional radiology team members at the University of Rochester Medical Center in Rochester, NY, have implemented a cardiac arrest model


and code simulation to improve timing, accuracy and staff comfort.


“I come from a critical care background, and when I transitioned to my role in IR, I saw an opportunity to improve our code response,” said Shannon Woughter, PA. “We often don’t have a lot of training on our code responses—however, we are taking care of increasingly sicker patients that need more medical care. When you work in a large medical center, sometimes it takes a few minutes for the code team to arrive. Those fi rst couple of minutes are essential for good patient outcomes.”


According to Woughter, there are over 200,000 hospital cardiac arrests annually, and these happen within the IR suite as well. With this in mind, there was a need to be better prepared.


Woughter, along with Lindsay Marchetti, PA; Charles Gorton, RN; Lisa M. Owen, RN; Adrienne Conrad, RN; Marco Ertreo, MD; and Andrew Cantos, MD, utilized simulation equipment from the cardiac ICU team to design and implement IR code simulations.


All staff members were preassigned roles to focus on, such as code leader, administering CPR, documenting, or administering medications or the defi brillator. They then wrote simulations for scenarios that commonly happen, posing some IR-specifi c issues with cardiac arrest, and then ran fi ve successful code simulations over a 10-month period.


16 IRQ | SPRING 2025


“One simulation that we felt was really helpful was a prone CT lung biopsy scenario,” Woughter said. “Essentially, the patient has arrested face down on the table—how can we fl ip them over quickly to start CPR, place pads and defi brillate them? Another scenario involved line placement with a tunnel line and focused on how quickly you could get out of the procedure and start CPR.”


The team also explored a simulation that took place in the recovery area. “In that scenario, a patient comes in for a routine procedure and then suddenly collapses. So how do we manage this in an outpatient area where we don’t have a lot of staff available quickly?”


In addition to tracking the time to CPR and defi brillation, the team also provided a 16-point survey that allowed staff to evaluate their experiences pre- and post-simulation. Respondents were asked to rank their confi dence and comfort with roles, code algorithms and expectations.


“We found that as we ran these simulations, staff confi dence increased,” Woughter said.


One surprising fi nding was a decrease in staff ’s ability to fi nd the code cart— though Woughter viewed this as an opportunity.


“It let us know what was a pain point and helped us provide better education and structure for improvement,” she said.


Overall, they found that the regular code simulations improved team organization, confi dence and communication, as well as decreasing time to CPR—factors that contribute to better patient outcomes.


Want more quality improvement content?


The Quality Improvement in Interventional Radiology course is free to members and equips participants with the knowledge and skills necessary to successfully initiate, execute and evaluate QI projects.


The course has two parts: building the framework and implementing action. The module emphasizes the use of the Plan-Do-Study-Act (PDSA) cycle for iterative improvement and teaches how to evaluate the scalability of projects across healthcare settings. Participants will also develop leadership skills for driving change and engage staff effectively in continuous improvement efforts—all while aligning project timelines with organizational goals and milestones.


Learn more and access at sirweb.org!


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