Abstract Body (Do not enter title and authors here): Background: Structured institutional cardiac resuscitation response training is critical to prepare healthcare workers to respond in emergencies. Best practices require context-adapted training while maintaining quality and fidelity. Resource-limited settings face unique challenges, including deficiencies in basic life support training, limited resources, and a lack of certified trainers. An approach to contextualize training, build capacity, and ensure long-term sustainability is needed.

Objective: To describe the adaptive approaches used to implement and scale up in-hospital cardiac arrest response training at a teaching hospital in northern Ghana, addressing specific challenges and focusing on long-term sustainability.

Methods: Leveraging an international academic partnership known as AMPATH Ghana, a multidisciplinary team designed an adapted cardiovascular life support training program inspired by the American Heart Association ACLS training. The program was tailored to local challenges, such as resource limitations, knowledge gaps, and institutional capacity (Table 1). Trainers used a combination of didactic learning, hands-on practice, simulations, and structured feedback. Participant surveys assessed the program’s impact and guided subsequent training iterations.

Results: 198 healthcare workers were trained over four iterations (74% nurses, 35% medical officers, 1% pharmacists). Before the training, 23.4% of trainees felt very confident in their ability to work effectively in a code situation. This increased to 75.3% post-training (p<0.001). With each iteration, adaptations enhanced training quality and fidelity. Medical officers (general practitioner level) were trained as co-facilitators after the first iteration, and additional resources were developed with institutional support to enhance fidelity and sustainability.

Conclusion: Through a bilateral academic partnership, an adaptive approach to contextually appropriate cardiac arrest response training has improved knowledge and healthcare worker confidence in a teaching hospital in northern Ghana. This adaptive approach may be replicated in similar resource-limited settings to effectively and sustainably scale up training and enhance healthcare capacity.