Veterans Affairs (VA) Veterans Health Administration (VHA) Resuscitation Education Products and Services

The Resuscitation Education and Innovation (REdI), within VHA Simulation Learning, Evaluation, Assessment, Research Network (SimLEARN) under the VHA Office of Healthcare Innovation and Learning (OHIL), is the VHA national program that is responsible for providing mandatory resuscitation education and training across the entire construct of the VHA for clinical and non-clinical employees.

VHA is mandated to maintain compliance with federal healthcare regulations and VHA directives to ensure staff competency in resuscitation techniques. Part of the training provision that the REdI program provides is national support services, training materials, standardized equipment, oversight and validation of local VA medical facility comprehensive resuscitation education programs. REdI serves as the subject matter expert to identify and administer all necessary courseware related to resuscitation in order to provide the necessary support services for VHA clinical and non-clinical employees to maintain and/or renew their required resuscitation education certification. The current environment consists of resuscitation education products and services to support a wide range of training to include Responder (Layperson training), HeartSaver (HS), Basic Life Support (BLS), Advanced Cardiovascular Life Support (ACLS), Advanced Stroke Life Support (ASLS), Pediatric Emergency Assessment, Recognition, and Stabilization (PEARS) and Pediatric Advanced Life Support (PALS). The requirement for certification is outlined in VHA Directive 1177, Cardiopulmonary Resuscitation, and VHA Directive 1101.14, Emergency Medicine, defines which clinical and non-clinical VHA employees are required to have the appropriate level of training in order to provide an emergency response to any patients, visitor or employee suffering from a clinical deterioration or medical emergency within a VA medical facility and surrounding campus.

REdI has shifted its focus to minimizing instructor-led training and implementing a self- directed, digital platform in order to minimize the amount of time a clinician is away from Veteran care. This technology allows nearly 275,000 VHA clinical and non-clinical employees across 172 VA medical facilities and their 1,200 associated Community Based Outpatient Clinics, to complete online eLearning courseware that uses scenario-based patient cases that facilitate interactive learning, knowledge and confidence assessments, and adaptability followed by a psychomotor skill assessment on a Mobile Cardiopulmonary (CPR) Testing Station with adult and infant manikins. This self-directed skill assessment provides real-time, objective feedback and on-going validation of competency for compressions and ventilations resulting in certification without the support of an instructor for layperson, basic, advanced and pediatric advanced life support. The current digital environment allows the learner flexibility in its modalities to complete the training every two years (traditional) or through a standardized, low-dose, high-frequency (LDHF) approach. Implementation of standardized LDHF training aligns with evidence- based education science to prevent skill degradation of critical life-saving skills and complies with federal healthcare accreditation regulations (i.e. The Joint Commission).

The current Government environment consists of existing system-wide VHA training equipment: 2050 Mobile CPR Testing Stations utilizing Laerdal QCPR Adult and QCPR Infant manikins that currently deploys the Responder (Layperson), BLS, ACLS and PALS courseware on the RQI 1Stop Platform. The current Government environment consists of current edition of digital and print education materials to support Heart Saver, BLS, ACLS, ASLS, PEARS and PALS training facilitated by 2,500 trained and approved VHA instructors.

The International Liaison Committee on Resuscitation (ILCOR) is the global network of resuscitation organizations that provides a consensus mechanism and forum for discussion and coordination of all aspects of cardiopulmonary and cerebral resuscitation worldwide. ILCOR evaluates and reviews the latest evidence on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) protocols that can be further defined by resuscitation organizations. ILCOR releases its updated recommendations in 5-year cycles, with the last round of updates being the 2020-2025 guidelines. Critical updates to resuscitation treatment guidelines, training and education are published based on ILCOR recommendations in 5-year cycles.