Corresponding author: Peter Arrowsmith, (Hamad International Training Center, Doha, Qatar) — parrowsmith@hamad.qa
Submitted: 16 Sep 2025 · Accepted: 13 Jan 2026
Early recognition of cardiac arrest and delivery of high-quality early resuscitation are critical for survival [1]. Performance during this phase remains inconsistent in healthcare settings [2]. Simulation-based multidisciplinary team (MDT) training has shown superior outcomes compared to traditional lecturing, especially when monitored by measurable key performance indicators (KPIs) [3]. Data collected by Resuscitation Officers from the Hamad International Training Centre revealed KPIs not being met (Table 1), prompting a revised training method at Hamad Medical Corporation’s (HMC) hospitals, in Qatar. This study aimed to evaluate the introduction of a MDT training program integrating response algorithms emphasizing the first five minutes on resuscitation KPIs in simulated clinical settings.
| Key Performance Indicator (KPI) | N (Pre- intervention) | N (Post- intervention) | Pre-mean Rank | Post-mean Rank | U | p-value |
|---|---|---|---|---|---|---|
| 1. Time to Recognize Absence of Breathing & Deliver 5 Breaths (≤30 s) | 80 | 80 | 55 | 82 | 1289 | <0.001 |
| 2. Code Blue/White Activation Time (≤1 min) | 80 | 80 | 57 | 80 | 1084 | 0.003 |
| 3. First Chest Compression Attempt (≤30 s) | 80 | 80 | 60 | 77 | 1190 | 0.012 |
| 4. Defibrillator Arrival Time (≤3 min) | 80 | 80 | 62 | 75 | 1300 | 0.029 |
| 5. Time to First Defibrillation Shock (≤1 min) | 80 | 80 | 58 | 79 | 1275 | 0.008 |
| 6. Code Blue/White Team Arrival Time (≤5 min) | 80 | 80 | 61 | 76 | 1350 | 0.045 |
A pre-/post-intervention study was conducted with 80 participants randomly allocated from newly formed MDT as per the shift roster at a newly opened HMC hospital providing diverse services. Each MDT consisted of two physicians and six nurses with defined roles, all with over 5 years of post-registration experience and qualified in Immediate Life Support or Paediatric Life Support. (European Resuscitation Committee 2021 guidelines). Performance was evaluated before and after the introduction of the revised training model. The initial sessions were skills-based (90 minutes of Basic Life Support airway and defibrillation) followed by a cardiac arrest simulation (30 minutes), latter sessions of the same duration were entirely simulation-based with coaching and emphasis on rapid assessment, timely recognition, and prompt initiation of interventions within the first five minutes of collapse, reinforced by the implementation of response algorithms (Figure 1). Data collection focused on six KPIs (Table 1).
Implementation of the MDT training program and response pathway algorithms replacing solely skills training, resulted in improvements across all KPIs (Table 1).
This training with algorithms improved performance across KPIs highlighting the significance of integrating clear response pathways and defined roles.
1. Hamad International Training Center, Doha, Qatar
2. Hamad Medical Corporation, Doha, Qatar
All authors contributed equally and validated the final version of record.
We would like to express our sincere appreciation to, Dr. M HA Nasser ALamri Snr. Con. Paeds for their continuous guidance and support. We also extend our gratitude to the leadership team and staff of Aisha Bint Hamad al Attiyah Hospital for their invaluable cooperation throughout this project.
The Authors declare that there is no conflict of interest.
This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
No registration applicable.
The data that support the findings of this study are available from the corresponding author upon reasonable request.
The study was approved as Quality improvement project by Director of Hamad International Training Centre.