Background /Goal of Study: 
Trends toward an improved survival rate in IHCA patients was recently demonstrated in both adult and pediatric patients. At a hospital level, evidence for beneficial interventions are scarce and controversial. We developped a program aimed at following the 2004 french guidelines. Our objective is to report on the effect of this program on IHCA survival over the last 7 years.
Materials /Methods: 
All IHCA were recorded on a database including demographic, location, comorbidity, initial rhythm, timing of treatments, length of stay, and outcome data. Interventions were : creation of a code number, 100% AED availability on wards, 2 successive code carts modifications, implementation of a staff education program (400 pax).We retrospectively analyzed the database over 13 half year categories. Chi-square test for trend was used to determine statistical significance of change in survival rate.
Results /Discussion: 
393 IHCA patients were treated from 01/01/09 to 30/06/15. Overall incidence density was : 4.28/1000 stay. Overall mean value were : age : 71+/-11, non shockable rhythms : 56.7%, time to CPR 1.29 min, immediate survival (IS) : 66.2%, hospital survival (HS) : 44.8%. Mean age slightly increased while time to CPR decreased over the study period (NS). Significant improvement in IS was reached after complete staff education. HS increase was reached after creation of the code number (26.7% to 45% ; p< 0.05). No other intervention achieved statistically significant changes. Survival decrease was observed after each structural changes in the institution with subsequent changes in the case-mix (NS).
Conclusion(s): 
Guidelines implementation significantly improved HS in the institution. HS increased over time and never went lower than before intervention. Staff education provided the largest increase in IS. Variations in survival rate over time are related to structural and case mix changes in the institution. Multiannual half-year trends are usefull to assess the sustainability of improvements.

Interventions to improve in-hospital cardiac arrest (IHCA) survival rate - a single center report