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Thought Leader Session

Guidelines Session

Aging Adult Track

Additional Registration Fee

Research Snapshot Theater: Quality and Patient Safety, Adult and Pediatric II

Adapting to Atypical Codes in a Children’s Hospital: Implementing a Modified Code Response Team

Sunday, March 22, 2026

11:00 AM - 12:00 PM Central Time

Location: Connections Central - RST 10

Beth Wathen, MSN, CCRN

Children's Hospital Colorado

Disclosure(s): No relevant financial relationship(s) to disclose.
LB

Lora Byrne, DM MBA BSN CNML

Director of Patient Care Services PICU, Codes Program, Kidney Center
Children's Hospital Colorado

Disclosure information not submitted.
JN

Jennifer Newman, MPH BSN RN CPPS

Clinical Nurse Database Coordinator, Codes Program
Children's Hospital Colorado

Disclosure information not submitted.
NF

Natalie France, MSN RN CCRN NPD-BC

Clinical Education Specialist, Codes Program
Children's Hospital Colorado

Disclosure information not submitted.
LB

Laura Barg-Walkow, PhD CHFP CPPS

Human Factors Engineer, Patient Safety
Children's Hospital Colorado

Disclosure information not submitted.
TB

Timothy Bonnell, PhD MBA CHEP CHSP

Chief of Security and Public Safety
Children's Hospital Colorado

Disclosure information not submitted.
NA

Niles Ackerson, N/A

Manager of Security Operations
Children's Hospital Colorado

Disclosure information not submitted.
RS

Rudy Sanchez, N/A

Guest Relations Manager
Children's Hospital Colorado

Disclosure information not submitted.
HA

Heather Arnette, BSN RN CPN

Nursing House Supervisor
Children's Hospital Colorado

Disclosure information not submitted.
KF

Kristina Formica, BSN RN CCRN

Associate Clinical Manager, Pediatric Intensive Care Unit
Children's Hospital Colorado

Disclosure information not submitted.
CB

Cortney Braund, MD

Medical Director, Emergency Department
Children's Hospital Colorado

Disclosure information not submitted.
TJ

Travis Justilian, RN CPN NE-BC

Director of Patient Care Services, Anschutz Emergency Department
Children's Hospital Colorado

Disclosure information not submitted.
CR

Christopher Ruzas, MD University of Colorado School of Medicine, Dept of Pediatrics, Section of Pediatric Critical Care

Associate Medical Director PICU, Associate Professor Univ of Colorado School of Medicine
Children's Hospital Colorado, University of Colorado

Disclosure information not submitted.
CG

Cameron Gunville, DO

Medical Director, Pediatric Critical Care Unit, Children's Hospital Colorado
University of Colorado At Children's Hospital Colorado

Disclosure information not submitted.

Introduction: Code team activations for adults at our children’s hospital continue to rise. In 2024, the code team responded to 287 activations. Of those, 115 (45%) involved adult non-patients. Additionally, 21% of those events involved code activations at entrances and outside areas of our campus, and some involved victims of intentional violence (VoIV). In 2023, video reviews of these code activations identified opportunities to streamline code response, prioritize a basic life support (BLS) focus, and minimize pulling critical care resources out of the ICUs for a BLS response.

Methods: Key stakeholders undertook a comprehensive risk assessment, evaluating code response at entrances and outside areas. As a result, a new code response model was developed, the Focused Assessment and Swift Transport Response (FASTR). FASTR is a nurse-led code team, comprised of a subset of the full code team. The smaller size of the FASTR team allowed for enhanced training with all FASTR responders prior to go-live. More than 160 code responders participated in a two-hour didactic and simulation-based training, which covered key concepts including scene safety, car extractions, CPR in transit, and other critical content. The FASTR program was implemented in February 2025.

Results: The FASTR team has responded to 18 activations since go-live. Baseline data from 2024 on the overall quality of code response at entrances or outside areas had 57% positive responses (excellent or good on Likert-type scale). Perception of safety during code response was only 51.2% positive response. When re-surveyed in July 2025, 100% of FASTR responders had positive responses on overall quality of code response. Additionally, 100% of responders indicated a positive perception of safety. Almost all (98%) indicated they feel the quality of the FASTR response in these scenarios is superior to full code team response, and that FASTR represents a more efficient response (90%), with more rapid disposition to the ED and enhanced role clarity.

Conclusions: FASTR represents a high quality, more efficient code team response, while allowing critical care expertise (intensivists, pharmacists, and anesthesiology providers) to remain in their respective departments. Focused training has also improved overall perceptions of safety during FASTR activations.