Abstract Body: This is a Promissory Abstract, and we will divulge actual results at ReSS

Importance: Since 2018, the Resuscitation Quality Improvement® (RQI) program to enhance cardiopulmonary resuscitation (CPR) skill retention through low-dose, high-frequency training has expanded to many U.S. hospitals.
Objective: Evaluate whether implementation of the RQI Provider program is associated with higher in-hospital cardiac arrest (IHCA) survival, compared with control (non-RQI) hospitals.
Design: Cohort study of 237 U.S. hospitals participating in Get With The Guidelines-Resuscitation during 2017-2023. Control hospitals were uniquely matched to a RQI hospital if they had a 2-year risk-standardized survival rate (RSSR) to discharge that was within 1% of the RQI hospital’s RSSR during the 2-year preintervention period before RQI adoption, and both had annual IHCA case volume that was within 50 cases of each other. Hierarchical models were used to conduct a difference-in-difference analysis to compare the 2-year postintervention vs. 2-year preintervention IHCA survival rates at RQI vs. control hospitals.
Exposure: Implementation of the RQI Provider program.
Main Outcomes: RSSR to hospital discharge (primary outcome) and return of spontaneous circulation (secondary outcome).
Results: Of 237 hospitals, 107 control hospitals were matched to 18 RQI hospitals (5 in 2019, 8 in 2020, and 5 in 2021), comprising a total of 49,870 IHCAs. Mean RSSR to hospital discharge at RQI hospitals was X% + X% in the preintervention period and X% + X% in the postintervention period, whereas mean RSSR at control hospitals was X% + X% and X% + X%. When postintervention vs. preintervention survival rates were compared between the groups, RQI adoption was (or was not) associated with improvements in survival to discharge (difference-in-difference adjusted OR: X.XX [95% CI: X.XX, X.XX]; P=0.XX). For ROSC, mean RSSR at RQI hospitals was X% + X% and X% + X% in the preintervention and postintervention periods whereas it was X% + X% and X% + X% at control hospitals. When postintervention vs. preintervention ROSC rates were compared, RQI adoption was (or was not) associated with higher rates of ROSC (difference-in-difference adjusted OR: X.XX [95% CI: X.XX, X.XX]; P=0.XX).
Conclusions: In a national registry of IHCA, compared to control hospitals, hospital adoption of the RQI Provider program was (or was not) associated with improved rates of survival to discharge and ROSC in the two years after implementation.