Executive Summary

Improving Code Blue performance is a top Medstar priority. Medstar implemented xapiapps as part of an xAPI ecosystem to address performance issues such as:

  • Delays in defibrillation. Lack of device knowledge
  • Lack of process/algorithm knowledge
  • Team coordination issues

xapiapps is used by medical observers to collect fine-grained data on how teams work together in a mock code blue simulation.

The data collected through xapiapps provided insights into how clinicians are applying their training and provides ongoing opportunities to improve learning design.


Providing care to more than 500,000 patients each year, MedStar Health is the largest healthcare provider in the Washington, D.C./Maryland region. As an organization, they’re committed to providing the best care during emergency situations in which patients are in cardiopulmonary arrest (referred to as “Code Blues”).

During a Code Blue, the stakes are literally life and death—which is why it’s vital that MedStar resuscitation team members are well trained. Speed is vital in the seconds and minutes that follow a Code Blue, including the amounts of time for performing chest compressions and defibrillation and administering medications to a patient.

As a result, MedStar’s Code Blue training and learning resources have focused on improving clinician performance to reduce these times. However, MedStar didn’t have extensive information on the effectiveness of various training programs and learning resources.

How xapiapps Helped

Medstar decided that the most realistic way to simulate the measure the application of resuscitation training was to create ‘Mock Code Blues’.

A medical resuscitation mannequin is placed within areas of the hospitals. As staff encounter the mannequin they participate in the ‘Mock Code Blue’. A Medical Educator uses the xapiapps Group Observation App to record information on the participants, the resuscitation processes and any problems encountered. This data is then used to address training issues.

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Through the collection of data in xapiapps, Medstar can now analyse how staff are performing in Mock Code Blue and identify where problems are occurring

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This report shows how KPIs for Mock Code Blues on a department by department basis.

Figure 1 - Not actual data.

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