Human Factors-Driven Optimization of Pediatric Resuscitation Workflow Using Integrated Color-Coded Systems: A Randomized Crossover Study.

AIM: This study evaluated whether a human factors-driven, integrated, color-coded resuscitation system that combines equipment standardization and prefilled-medication cognitive aids improves workflow efficiency and accuracy compared with a conventional crash cart during simulated pediatric resuscitations.

METHODS

A prospective, randomized, crossover simulation study was conducted with 28 health care professionals. Each team participated in 2 pediatric resuscitation scenarios using either the SCC or the CCCC in random order. All sessions were video-recorded to measure equipment retrieval and medication preparation times. Statistical comparisons were made using paired statistical tests appropriate for crossover designs, with significance set at P<0.05.

RESULTS

Use of the CCCC significantly reduced the time to locate airway devices (13.1±6.9 vs. 41.7±22 s, P<0.001) and airway adjuncts (13.8±11.9 vs. 30.8±17.4 s, P=0.03). Prefilled color-coded syringes significantly reduced medication preparation time (median: 16 vs. 19 s; absolute reduction 3 s, P=0.04), with no dosing errors observed. Teams using the CCCC demonstrated more consistent workflow and fewer procedural delays.

CONCLUSIONS

In this randomized crossover simulation study, the integrated color-coded system reduced equipment retrieval and medication preparation times for selected pediatric resuscitation tasks. These findings are limited to the simulation setting and should be interpreted in light of the Broselow framework's use for both cart organization and assessment of correct equipment selection. Further research is needed to evaluate the feasibility of color-coded prefilled syringes and determine whether the observed workflow benefits translate to real-world pediatric patient care.