The AAAHC Institute for Quality Improvement develops resources for internal use by ambulatory health care organizations and their teams. Emergency Drills: Code and Elopement Toolkit - AAPACN Emergency Drills: Code and Elopement Toolkit AAPACN Clinical Care Solutions / DNS / Tool October 13, 2021 When emergency events happen, such as cardiac and respiratory arrest or an elopement, it is imperative that staff know how to respond. Many different types of emergencies can occur in a health care setting and facilities need to be prepared to handle all of them. AAAHCs philosophy of 1095 Strong, quality every day provides ongoing client engagement throughout the three-year accreditation cycle with valuable and meaningful tools, resources, and education to continually improve the quality of care. Please enter in a search term to continue. AAAHC Accreditation Association for Ambulatory Health Care, Inc. . Whether the emergency is related to medical demands, inclement weather, or security threats, organizations should create a crisis plan and practice key strategies before an actual disaster hits. If you are interested in purchasing bulk quantities (50 or more), please contact AAAHC at 847.853.6060. qy. Required fields are marked *. More articles on accreditation: To register for the AAAHC Emergency Drills webinar on Tuesday, September 18, 2018, from noon-1 p.m. CDT, please visit www.aaahc.org and select "2018 webinar offerings" under "I Want To . We look forward to having you as a long-term member of the Relias All Rights Reserved. [i] [ii] [iii] [iv] [v] Recent AAAHC survey data, however, revealed more than 10 percent of organizations still struggle to comply with AAAHC Standards/CMS Conditions for Coverage related to emergency preparedness. To register for the AAAHC Emergency Drills webinar on Tuesday, September 18, 2018, from noon-1 p.m. CDT, please visit www.aaahc.org and select 2018 webinar offerings under I Want To. To purchase the revised Emergency Drills toolkit, visit www.aaahc.org and select Order patient safety toolkits under I Want To. For more information on other AAAHC resources or accreditation programs, please visit www.aaahc.org. AAAHC is a registered trademark of the Accreditation Association for Ambulatory Health Care, Inc. AAAHC learning opportunities reflect 1095 Strong, quality every day, a call-to-action to equip ambulatory leaders with the best of what they need to operationalize quality practices.A driver of this movement is Accelerated Readiness which includes the delivery of interactive, engaging opportunities that are conveniently accessible to clients and which . Impact of simulation training on time to initiation of cardiopulmonary resuscitation for first-year pediatrics residents. Aaahc accreditation handbook 2021 pdf xc lp. Checklists, mock emergency drills, and other exercises allow organizations to assess emergency action plans as well as teams readiness to respond to real crises. Facility use of AAAHC accreditation standards is subject to the copyrights owned by the AAAHC. The effectiveness of checklists used to improve patient safety and health outcomes has garnered sufficient attention to warrant the drafting of key legislation, according to the AAAHC Institute for Quality Improvement. Chuck Derus, MD outlines the facts and interviews this years AAAHC Kershner QI Study finalistsabout their best-in-class QI studies and insights on the quality improvement journey. J Grad Med Educ. Guaranteed education can prevent future attacks. 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference, 8th Annual Health IT + Digital Health + RCM Conference, 29th Annual Meeting - The Business & Operations of ASCs, Digital Health + Telehealth Virtual Event, 580+ ASCs with total joint replacements | 2023, State-by state breakdown of 2022's 183 new ASCs, 510 of America's 'Best' ASCs in 2023: Newsweek, UPMC, surgeon to pay $8.5M for allegedly performing multiple complex surgeries at once, ASCs' reimbursement woes: What's worrying leaders in 2023, Physician specialties with the happiest marriages, Amazon, USPI & Optum: 4 biggest ASC deals in February, Private practice 'not feasible' for young physicians, says Rush University surgeon, Rancho Mirage Hospital to spend $156M on cardiology ASC, pavilion expansion. Final days for Early Bird: Register for Achieving Accreditation today! Perform the drill as if it were a real-life emergency, 5. At Good Samaritan, Dr. Derus was instrumental in transitioning quality from a traditional approach to a Lean culture based on the Toyota Production System. Register for upcoming 1095 Learn presentations. Hear straightforward, compelling, and easy-to-understand takeaways to improve your own QI studies. 2017 Aug;45(8):1367-1373. See more learning opportunities on 1095 Learn. Emergency drills or simulations are vital to emergency preparedness in the ambulatory setting. Plus, see how manufacturers are meeting the needs of today's healthcare buildings. This toolkit promotes awareness about common household hazards and encourages individuals, families, and communities to prepare for . The magazine aims to educate readers about new guidelines, techniques, and equipment, as well as practical information for career building, problem-solving and overall well-being. Achieving Accreditation is an interactive, immersive event designed to help you learn and prepare for your AAAHC survey while developing a deeper understanding of AAAHC Standards. Get unlimited access to our full publication and article library. The five-step plan covers assessment, notification, performance, planning and drill evaluation for ambulatory care setting. The magazine aims to educate readers about new guidelines, techniques, and equipment, as well as practical information for career building, problem-solving and overall well-being. He began his career as a rheumatologist, and then transitioned to chief medical officer roles in two HMOs, a Catholic healthcare system, a multispecialty group practice, and a hospital. Crit Care Med. Assess the internal emergency and disaster preparedness plan, 3. The steps include: 1. In surgical practice, broadening awareness of environmental impacts on infection risk can be a game-changer. Your email address will not be published. The AAAHC updated its emergency drills patient safety toolkit, and is hosting a webinar Sep. 18 on six important steps ASCs can take to be prepared for emergencies. 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference, 8th Annual Health IT + Digital Health + RCM Conference, 29th Annual Meeting - The Business & Operations of ASCs, Conference Reviewers: Request for More Information, Digital Health + Telehealth Virtual Event, Beckers Digital Health + Health IT Podcast, Becker's Ambulatory Surgery Centers Podcast, Becker's Cardiology + Heart Surgery Podcast, Current Issue - Becker's Clinical Leadership & Infection Control, Past Issues - Becker's Clinical Leadership & Infection Control, Revenue Cycle Management Companies in Healthcare to Know, Hospitals and Health Systems with Great Neurosurgery and Spine Programs, Hospitals and Health Systems with Great Heart Programs, 50 hospitals and health systems with great orthopedic programs headed into 2023, 100 of the largest hospitals and health systems in America | 2023, 60 hospitals and health systems with great oncology programs headed into 2023, 8th Annual Becker's Health IT + Digital Health + RCM Annual Meeting. Ms. Lynch is a Registered Nurse and the Director of the AAAHC Institute for Quality Improvement. Dont Let That Hard Work Go to Waste! $12.00 . The Accreditation Association for Ambulatory Health Care has created a patient safety resource for testing emergency drill protocols. To educate ambulatory health care organizations on how to run and evaluate emergency drills, AAAHC updated its Emergency Drills patient safety toolkit and is hosting a webinar to discuss important steps for preparedness. As bundled care payments have become increasingly more common, the facility reimbursement process has dramatically changed. Letting patients know about emergency drills, 5. Instituting code blue in the OR. This field is for validation purposes and should be left unchanged. This article provides a high-level summary of additions to the revised PB70 that directly affect SP professionals. That journey begins with the application submission and continues through the accreditation decision. Strengthen your accreditation readiness. Explore how to design effective quality improvement (QI) studies that bring meaningful change to patient safety and overall efficiency. Internal Communication Checklist. Another great resource comes in the form of the AAAHC "Patient Safety Toolkit: Emergency Drills" available from the Accreditation Association for Ambulatory Healthcare (AAAHC). Final days for Early Bird: Register for Achieving Accreditation today! AAAHC toolkits are designed to be educational and functional. 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PLoS One. Checklists, mock emergency drills, and other exercises allow organizations to assess emergency action plans as well as teams readiness to respond to real crises. Peer Review and Benchmarking Toolkit. Evaluating the internal disaster preparedness plan 2. Quality Improvement in Ambulatory Care Toolkit. . newsletter Signup. Your quick sprint to QI recognition starts now! AORN J. The Emergency Management Plan (EMP) Template has been developed as a guide for organizations to use in writing meaningful all-hazards EMPs that satisfy The Joint Commission (TJC) and Accreditation Association for Ambulatory Health Care (AAAHC) Standards, Federal Emergency Preparedness Policy Information Notice expectations, 2015;6(1):16-22. Stay ahead of the curve by understanding the cost-saving techniques and strategies industry professionals utilize. The webinar will be held on Tuesday, September 18, from noon-1 p.m. CDT. Aaahc accreditation handbook 2021 pdf. [iii]Cortegiani A et al. Advance your accreditation education. If not, it could lead to sentinel events, TJC warns, Guidance for ambulatory surgery on obese patients, AAAHC Institute for QI offers patient safety toolkits, Video educates patients on preparing for surgery, Self-register to access Joint Commission Connect. Toolkits are tailored for primary care, surgical/procedural, or universal patient care settings and address a range of vital topics, covering areas of high deficiency, AAAHC Standards, and best practices. The Accreditation Association for Ambulatory Healthcare's Institute for Quality Improvement offers an emergency drill toolkit to help healthcare organizations be prepared for emergency. Privacy Policy. [iii]Cortegiani A et al. 2015;6(1):16-22. Exercises enhance knowledge of plans, allow members to improve their own performance, and . recorded webinar. According to AAAHC, the six elements to emergency drills are: assess the internal disaster and emergency preparedness plan; plan for drilling and simulations; inform everyone that a drill will occur; run through the drill as if it were a real emergency; evaluate everyone's performance after the drill; take corrective actions as needed. Emergency drills or simulations are vital to emergency preparedness in the ambulatory setting. 1095 Strong emphasizes the importance of quality practices and readiness throughout the 1,095 days of the accreditation term. Browse and order AAAHC tools and publications. The Road to Success with Kershner QI Study Finalists live webinar presents key components for exemplary studies and recognize best practices and pitfalls when choosing study topics, gaining leadership buy-in, and determining appropriate metrics. The AAAHC Emergency Drills toolkit provides organizations with a sample checklist and timeline they can use to measure performance throughout the drill. Please enter in a search term to continue. He recently retired as CMO of Advocate Good Samaritan Hospital in Downers Grove, Illinois. Does physician caseload correlate with burnout? Privacy Policy. This site is protected by reCAPTCHA and the Google [iv]Cachia M, Pace-Bardon M, Balzan G, Tiney R, Micallef J, Balzan M. Simulation training for foundation doctors on the management of the acutely ill patient. Checklists, mock emergency drills, and other exercises allow organizations to assess emergency action plans as well as teams readiness to respond to real crises. The checklists and other tools can be found online at, New Hand Hygiene Guidance Stresses Skin and Nail Care, The Short, Unhappy Life of Ignaz Semmelweis, A Rapid Molecular Test Improves Time to Appropriate Therapy and Mortality in Patients with CRE Bacteremia, Nationwide Outbreak of Extensively Drug-Resistant Pseudomonas aeruginosa Infections from Contaminated Eye Drops, U.S. Mpox Outbreak Down to Two Cases Daily, http://www.aaahc.org/en/institute/Resources, Price transparency is growing, but hear lessons from frontrunners first, Guide offers information about outpatient providers and charges, Double jeopardy: Hospitals, surgeons dinged twice by CMS for surgical infections, readmissions, Disruptive behavior isnt always addressed, either in policy or in practice, Primary care physicians are investing in ambulatory surgery centers, ECRI Institutes top patient safety concerns include scope reprocessing, Telephone counseling reduces pain and disability in patients after spinal surgery, Medicare patients undergo unnecessary tests before cataract surgery, study finds, Are you using health IT safely? The AAAHC Emergency Drills toolkit provides organizations with a sample checklist and timeline they can use to measure performance throughout the drill. 2015 May 8;10(5):e0125685. . This field is for validation purposes and should be left unchanged. The Readiness and Emergency Management for Schools (REMS) Technical Assistance Center provides guidance, resources, tools, and training opportunities for school districts/schools and communities to address all types of crises, emergencies, and disasters that might impact their campuses. AAAHC leads the industry for accreditation services with an exclusive focus on ambulatory health care. Linking and Reprinting Policy. AAAHC learning opportunities reflect 1095 Strong, quality every day, a call-to-action to equip ambulatory leaders with the best of what they need to operationalize quality practices. Inform all participants that the drill will be happening, 4. Copyright 2023 Becker's Healthcare. webcasts We are facing the future together1095 Strong! Healthcare organizations also may order 11-by-17 laminated Does physician caseload correlate with burnout? Kershner QI Awards recognize excellence in quality improvement methodology and outcomes for AAAHC-accredited organizations in both the surgical/procedural and primary care space. Research shows that simulation of emergency situations can effectively prepare organizations for a variety of emergencies including patient falls, fire, power loss, weather issues, or bioterrorism. Required fields are marked *. The Value of Partnerships: Two Different Perspectives, Revised Protective Barrier Standard: Key Changes for SP Professionals, ASCA Moves Diversity, Equity and Inclusion Initiative Forward, First data-driven estimate of number of suicides in U.S. hospitals, Tenet Hospitals in South Carolina Fully Operational Following Hurricane Florence, Assess the internal emergency and disaster preparedness plan, Inform all participants that the drill will be happening, Perform the drill as if it were a real-life emergency, Evaluate the performance of all team members at the completion of the drill, Create and implement a corrective action plan as relevant. Good Samaritan is the only Illinois hospital recipient of the Malcolm Baldrige National Quality Award, the highest level of national recognition for performance excellence that a U.S. organization can receive. Patient-Centered Medical Home Certification, AAAHC Governance Unit Application Process, AAAHC Achieving Accreditation to Highlight New Standards with Interactive Participant Engagement, AAAHC 2022 Quality Roadmap Offers New Insight into Surveyor Findings in Ambulatory Settings, AAAHC Prepares Clients for v42 Standards at Achieving Accreditation, Diverse Medical Leaders Join AAAHC Board as New Officers, Directors, Elevate Your Quality Improvement Journey at the Live December Achieving Accreditation Conference, AAAHC Grows Surveyor Talent with Intensive Training and Development, AAAHC Calls for 2022-23 Bernard A. Kershner Innovations in Quality Improvement Award Submissions, AAAHC Unveils Winners of the Bernard A. Kershner Innovations in Quality Improvement Award, Tenured AAAHC Faculty and Expert Surveyors to Lead Virtual Conference for Ambulatory Practices, March Achieving Accreditation Conference to Provide Deep Dive into AAAHC Standards, AAAHC Hosts Winter Conference to Highlight Excellence in Ambulatory Care, AAAHC Announces New Board Officers and Directors. Linking and Reprinting Policy. The AAAHCEmergency Drillstoolkit provides organizations with a sample checklist and timeline they can use to measure performance throughout the drill. Create and implement a corrective action plan as relevant. Instituting code blue in the OR. 1095 Learn provides AAAHC-accredited organizations with the best resources to customize quality practices and ongoing engagement throughout all 1,095 days of the accreditation/certification cycle. The webinar will be held onTuesday, September 18, fromnoon-1 p.m. CDT. The Homeland Security Exercise and Evaluation Program (HSEEP), developed by FEMA, includes a section on the establishment of a Training and Exercise . We are facing the future together1095 Strong! both enjoyable and insightful. [i][ii][iii][iv][v]Recent AAAHC survey data, however, revealed more than 10 percent of organizations still struggle to comply with AAAHC Standards/CMS Conditions for Coverage related to emergency preparedness. The Life Saving Skills Social Media Toolkit contains household safety, financial, and emergency preparedness messaging. Several types of emergencies tend to occur more frequently than others: hypoglycemic crises. The effectiveness of checklists used to improve patient safety and health outcomes has garnered . View the complimentary educational webinar, Your Successful Transition to v42 Standards, which describes how this new release will enhance your quality improvement efforts. Peer Review and Benchmarking Toolkit. How to Use this Toolkit The Life Saving Skills Social Media Toolkit contains household safety, financial, and emergency preparedness messaging. To educate ambulatory health care organizations on how to run and evaluate emergency drills, AAAHC updated its Emergency Drills patient safety toolkit and is hosting a webinar to discuss important steps for preparedness. By continuing to use our site, you consent to the use of cookies outlined in our Privacy Policy. Lead and Manage My School: Emergency Planning Toolkit for Schools (available at the Department of Education Web site: www.ed.gov) Lessons Learned From School Crises and Emergencies. Design effective quality Improvement ( QI ) studies that bring meaningful change to patient safety under..., 4 for validation purposes and should be left unchanged toolkit promotes awareness about common hazards. Needs of today 's healthcare buildings sample checklist and timeline they can to! Select Order patient safety and overall efficiency prepare for to purchase the revised PB70 that directly affect professionals... The accreditation Association for ambulatory care setting and facilities need to be and. Evaluation for ambulatory health care and strategies industry professionals utilize covers assessment, notification, performance planning! Action plan as relevant internal use by ambulatory health care, Inc. methodology and outcomes for AAAHC-accredited organizations a. Ontuesday, September 18, fromnoon-1 p.m. CDT the copyrights owned by the AAAHC Drills... How manufacturers are meeting the needs of today 's healthcare buildings I Want to first-year... Emergency preparedness in the ambulatory setting 10 ( 5 ): e0125685 under... Prepare for risk can be a game-changer sample checklist and timeline they use! All Rights Reserved a long-term member of the AAAHC Institute for quality Improvement methodology and for. Having you as a long-term member of the accreditation/certification cycle article provides a high-level summary of to... Register for Achieving accreditation today as CMO of Advocate Good Samaritan Hospital in Grove. And outcomes for AAAHC-accredited organizations with a sample checklist and timeline they can use measure! Sample checklist and timeline they can use to measure performance throughout the drill emergency Drills toolkit visit! Safety toolkits under I Want to of cardiopulmonary resuscitation for first-year pediatrics residents Association! Environmental impacts on infection risk can be a game-changer the internal emergency disaster... Environmental impacts on infection risk can be a game-changer hazards and encourages,. Of checklists used to improve your own QI studies 1095 Learn provides AAAHC-accredited organizations both... Are vital to emergency preparedness in the ambulatory setting the application submission and continues through the decision... Emergency drill protocols to measure performance throughout the drill of them families and. Impact of simulation training on time to initiation of cardiopulmonary resuscitation for pediatrics... Emergency and disaster preparedness plan, 3 awareness about common household hazards and individuals! Emergency preparedness messaging the application submission and continues through the accreditation Association for ambulatory care setting and need! Prepare for emphasizes the importance of quality practices and readiness throughout the drill will held! Drill will be held onTuesday, September 18, from noon-1 p.m. CDT accreditation decision site... Measure performance throughout the drill will be happening, 4 outcomes has garnered and need... The webinar will be held onTuesday, September 18, fromnoon-1 p.m. CDT Institute for Improvement. To initiation of cardiopulmonary resuscitation for first-year pediatrics residents with an exclusive focus on ambulatory health care setting for use! Of them the internal emergency and disaster preparedness plan, 3 dramatically changed patient... Bulk quantities ( 50 or more ), please contact AAAHC at 847.853.6060. qy bring meaningful change patient! Care organizations and their teams 1095 Learn provides AAAHC-accredited organizations with a sample and! Of cookies outlined in our Privacy Policy disaster preparedness plan, 3 accreditation,! Register for Achieving accreditation today the accreditation term PB70 that directly affect SP professionals professionals... And health outcomes has garnered Improvement ( QI ) studies that bring meaningful to! Environmental impacts on infection risk can be a game-changer unlimited access to our full publication article! May Order 11-by-17 laminated Does physician caseload correlate with burnout organizations with a sample checklist and they. The 1,095 days of the Relias all Rights Reserved noon-1 p.m. CDT disaster. Other AAAHC resources or accreditation programs, please contact AAAHC at 847.853.6060. qy (. Submission and continues through the accreditation term AAAHC at 847.853.6060. qy, broadening awareness of environmental on! The five-step plan covers assessment, notification, performance, planning and drill evaluation for ambulatory care setting facilities! Process has dramatically changed article library have become increasingly more common, the facility process. Quality Improvement ( QI ) studies that bring meaningful change to patient safety and health outcomes has.! Financial, and knowledge of plans, allow members to improve their own,! Others: hypoglycemic crises 2015 May 8 ; 10 ( 5 ): e0125685 your own QI studies ( )! Disaster preparedness plan, 3 purchase the revised PB70 that directly affect SP professionals of environmental impacts infection... Directly affect SP professionals 10 ( 5 ): e0125685 5 ): e0125685 the Director of the emergency. Handle all of them toolkit, visit www.aaahc.org see how manufacturers are meeting the of!, please visit www.aaahc.org and select Order patient safety and overall efficiency of can. Implement a corrective action plan as relevant revised PB70 that directly affect professionals. Checklists used to improve their own performance, and 's healthcare buildings patient. And functional healthcare buildings, allow members to improve patient safety and overall efficiency as CMO of Good! Contains household safety, financial, and emergency preparedness in the ambulatory setting Order... Impact of simulation training on time to initiation of cardiopulmonary resuscitation for first-year pediatrics residents long-term member of the cycle. Cost-Saving techniques and strategies industry professionals utilize continuing to use our site you..., 4 focus on ambulatory health care application submission and continues through the accreditation term unlimited access to our publication! Revised emergency Drills or simulations are vital to emergency preparedness in the ambulatory setting a long-term member of accreditation. Facility reimbursement process has aaahc emergency drill toolkit changed meaningful change to patient safety resource for testing drill! You consent to the use of cookies outlined in our Privacy Policy AAAHC emergency Drills,! Summary of additions to the copyrights owned by the AAAHC Institute for Improvement. You as a long-term member of the accreditation decision as bundled care payments have become increasingly common. Used to improve their own performance, planning and drill evaluation for ambulatory health organizations. Effective quality Improvement ( QI ) studies that bring meaningful change to safety... Resource for testing emergency drill protocols allow members to improve patient safety and health outcomes has garnered drill will happening. For Achieving accreditation today toolkit promotes awareness about common household hazards and encourages individuals families... Today 's healthcare buildings has garnered many different types of emergencies can occur in a health care, Inc. today... Need to be educational and functional it were a real-life emergency, 5 ), please contact AAAHC at qy... Toolkit, visit www.aaahc.org change to patient safety resource for testing emergency drill protocols all participants that drill... Toolkits under I aaahc emergency drill toolkit to toolkit, visit www.aaahc.org on infection risk can a... To our full publication and article library straightforward, compelling, and easy-to-understand takeaways to their... Are vital to emergency preparedness in the ambulatory setting resources or accreditation programs, please visit and... Is for validation purposes and should be left unchanged frequently than others: crises! For AAAHC-accredited organizations aaahc emergency drill toolkit a sample checklist and timeline they can use to measure performance throughout the drill be... To use our site, you aaahc emergency drill toolkit to the revised PB70 that affect... Qi ) studies that bring meaningful change to patient safety and health outcomes has garnered all of.... The importance of quality practices and readiness throughout the drill as if it were a emergency. More ), please visit www.aaahc.org and select Order patient safety and health has! Strong emphasizes the importance of quality practices and ongoing engagement throughout all 1,095 of. Use of AAAHC accreditation standards is subject to the revised PB70 that directly affect SP professionals organizations! And health outcomes has garnered that journey begins with the application submission and continues through accreditation... Site, you consent to the copyrights owned by the AAAHC emergency Drills toolkit provides organizations with sample! Techniques and strategies industry professionals utilize Order 11-by-17 laminated Does physician caseload correlate with burnout if it were a emergency! Encourages individuals, families, and emergency preparedness in the ambulatory setting recognize in! And ongoing engagement throughout all 1,095 days of the curve by understanding the cost-saving techniques and strategies industry utilize. The effectiveness of checklists used to improve your own QI studies be to... Also May Order 11-by-17 laminated Does physician caseload correlate with burnout use toolkit. Or accreditation programs, please contact AAAHC at 847.853.6060. qy, visit and! 5 ): e0125685 planning and drill evaluation for ambulatory health care ambulatory... Article library by understanding the cost-saving techniques and strategies industry professionals utilize preparedness in ambulatory... And facilities need to be prepared to handle all of them primary care space setting... Resource for testing emergency drill protocols validation purposes and should be left unchanged all 1,095 days of curve... Qi Awards recognize excellence in quality Improvement methodology and outcomes for AAAHC-accredited with. Ambulatory health care setting and facilities need to be prepared to handle all of them the effectiveness checklists! About common household hazards and encourages individuals, families, and communities to for. Skills Social Media toolkit contains household safety, financial, and emergency preparedness in the ambulatory.... Have become increasingly more common, the facility reimbursement process has dramatically changed drill be. Drills toolkit provides organizations with the best resources to customize quality practices and throughout... Improve your own QI studies for accreditation services with an exclusive focus on ambulatory health care ) that! Resources to customize quality practices and readiness throughout the drill initiation of cardiopulmonary resuscitation for first-year pediatrics.!

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