title: A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.
abstract: Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication.
  
  
  
  This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital.
  
  
  
  The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred.
  
  
  
  "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training.
authors.affiliation: Department of Anesthesia, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Anesthesia, University of Toronto, Toronto, Ontario, Canada. Electronic address: katherine.taylor@sickkids.ca.
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Taylor
authors.affiliation: Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Parshuram
authors.affiliation: Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Ferri
authors.affiliation: Department of Critical Care Medicine, Hospital for Sick Children, Toronto, Ontario, Canada; Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Briseida
authors.initials: B
authors.lastname: Mema
mesh_terms: D003142:Communication; D003422:Critical Care / Q000379:methods; D017144:Focus Groups; D066296:Grounded Theory; D006801:Humans; D033183:Interdisciplinary Communication; D007857:Leadership; D008297:Male; D009726:Nurses; D010348:Patient Care Team / Q000458:organization & administration*; D010372:Pediatrics / Q000379:methods; D010819:Physician's Role; D010820:Physicians; D015397:Program Evaluation; D036301:Qualitative Research; D012151:Resuscitation / Q000379:methods*
keywords: Communication; Health care team; Process assessment (health care); Professional role; Resuscitation