The code blue response at Tamarack Health in Ashland experienced inconsistencies that posed potential risks for patient outcomes. Previously, each department managed its own code carts, with nursing teams responsible for checking expiration dates and restocking supplies at scheduled intervals. To improve reliability, the team hypothesized that standardizing the components of the code carts could enhance patient outcomes.

Background: Code team members reported that responses varied depending on how carts were set up. In January 2022, the Tamarack Health Cardiac Rehab Department planned to relocate from the second floor to the first floor, prompting a review of code cart setup, location, and response protocols. At that time, oversight and management of the carts were decentralized.

Assessment: The organization had twelve code carts with similar supplies. Nursing staff managed expiration dates, but decentralized ownership led to inconsistencies.

Recommendations Implemented: The Materials Management department took over ownership of the code carts, creating a centralized system. They established a visual management board to track the status of all twelve carts, driven by proactive expiration date management. Supplies nearing the end of their life within three months were removed from carts and redirected to high-use areas to avoid waste. Used code carts were returned immediately to a designated location in the Materials Department, ensuring a ready cart was always available to replace it. This process allowed for uniformity, centralized oversight, and risk-controlled updates for all carts.

Tamarack Health Ashland Staff Testimonials: “It’s been really helpful to know that in an emergency everything will be stocked and right where you expect to find it,” said an Emergency Room RN at Tamarack Health-Ashland.

“The process and labels are well defined, reducing confusion during a code. This keeps people focused on their specific tasks rather than searching for items in the crash cart, and it helps prepare the cart for the next emergency more efficiently,” added a House Supervisor at Tamarack Health-Ashland.

This new centralized system has significantly improved the reliability and efficiency of the code blue response, ensuring all code carts are uniform and fully stocked for emergencies.